Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry. The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer. The Fifth Edition also offers new or expanded coverage of: • “Moral hazard,” and its application in health insurance and managed care • The ever expanding and evolving payment systems and methodologies used in the U. S. Healthcare System • The role of benefits design along with discussion about medical necessity and its impact on benefits coverage • The impact of limitations on sales, governance and administrative (SG&A) costs and profits • Continued changes in payment mechanisms such as value-based payment under the Medicare Improvement for Patients and Providers Act (MIPPA) • Medicare Part D, the drug benefit and the plans that offer it, as well as the complexities of Medicare Advantage payment plans, Medicaid expansion under ACA, and more.
Details e-book Health Insurance and Managed Care
🗸 Author(s): Peter R. Kongstvedt
🗸 Title: Health Insurance and Managed Care: What They Are and How They Work
🗸 Rating : 4.6 from 5 stars (118 reviews)
🗸 Languange: English
🗸 Format ebook: PDF, EPUB, Kindle, Audio, HTML and MOBI
🗸 Supported Devices: Android, iOS, PC and Amazon Kindle
Readers' opinions about Health Insurance and Managed Care by Peter R. Kongstvedt
Delve into the pages of this engrossing historical fiction novel, where the past comes alive in vivid detail. Set against the backdrop of a bygone era, the story follows the lives of ordinary people caught up in extraordinary events. With its richly drawn characters and immersive storytelling, this book offers a glimpse into a world long gone but not forgotten.
This comprehensive guide to healthy living offers practical advice and science-backed tips for achieving optimal health and wellness. From diet and exercise to stress management and sleep hygiene, the author covers all the essential aspects of a balanced lifestyle. With its easy-to-follow recommendations and actionable strategies, this book is a valuable resource for anyone looking to improve their overall well-being.
Dive into a gripping thriller that takes readers on a pulse-pounding journey through the criminal underworld. Set in a gritty urban landscape, the story follows a determined detective as he races against time to catch a ruthless serial killer. With its twisty plot and nail-biting suspense, this book is guaranteed to keep readers on the edge of their seats.
Related ebooks of Health Insurance and Managed Care
Healing from Hidden Abuse: A Journey Through the Stages o...
Within every community, toxic people can be found hiding in families, couples, companies, and places of worship. The cryptic nature of psychological abuse involves repetitious mind games played by one individual or a group of people. Psychological abuse leaves no bruises. There are no broken bones. There are no holes in the walls. The bruises, brokenness, and holes are held tightly within the target of the abuse. Healing from Hidden Abuse walks the reader through…
The Everything Plant-Based Meal Prep Cookbook: 200 Easy, ...
Read more Read more Read more Black Bean Mango Salsa In a large bowl, add all ingredients and stir to combine. If salsa needs more zing, add more lime juice. Refrigerate leftovers in an airtight container for up to 5 days. Ingredients 1 (15-ounce) can low-sodium black beans, drained and rinsed ½ cup diced red onion ½ cup chopped fresh cilantro 1 large avocado, peeled, seeded, and chopped 1 large mango, peeled, seeded, and chopped…
Happy Gut: The Cleansing Program to Help You Lose Weight,...
Following the success of the bestselling Clean Gut and Wheat Belly comes this essential guide to improving digestive health from an expert in functional medicine—who reveals why everything that ails us, from fatigue to weight gain to bloating and bad skin, can be traced back to the gut, and shares his cleansing plan to help us reclaim our health.Dr. Vincent Pedre understands gut problems firsthand. He suffered from IBS for years before becoming an expert…
The Magic Mom: 5 Principles to Unlock Your Natural Gifts ...
Moms are the greatest entrepreneurs in the world, and raising the next generation of entrepreneurial women doesn’t happen by accident. Our daughters grow into the conversations we have around them. What kinds of conversations can we have so they grow into the best versions of themselves?In these pages, you’ll learn the formula of MAGIC which helps mothers create lives they love while leading their daughters to live powerfully:M (Model): How am I modeling who I…
Serpent & Dove Shut Your Mouth and Save Your Life (Illustrated) Corrupted Chaos: An Enemies to Lovers Forced Proximity Romance (Tarnished Empire) More Mediterranean: 225+ New Plant-Forward Recipes Endless Inspiration for Eating Well Ohio The Immunity Code: The New Paradigm for Immune Centric Health and Radical Anti-Aging. Spiritual Balancing: A Guidebook for Living in the Light How to Play the Trumpet: A Beginner’s Guide to Learning the Trumpet Basics, Reading Music, and Playing Songs with Audio Recordings Cribbage: How To Play And Win Warren Buffett’s Ground Rules: Words of Wisdom from the Partnership Letters of the World’s Greatest Investor
