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Essentials of Managed Health Care, 5th Edition

by Peter R. Kongstvedt

Summary

As the most widely-used textbook on managed care, Essentials of Managed Health Care provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well. This revision includes updates to all chapters, as well New chapters on disease management, case management, pharmacy benefits management, behavioral health management, prevention, and the use of data and analysis in care management. New chapters on claims administration, sales and marketing, healthcare consumerism, and the employer s view of managed health care. Completely revised chapter on the new Medicare/Medicaid laws and programs. New chapters on the military health system and managed care in a global context. New chapter on HIPAA.