ESSENTIALS OF MANAGED HEATH CARE 4E: .

by Peter R. Kongstvedt

The fourth edition of this popular textbook provides the basic information needed to learn critical concepts of managed care. Derived from the best-selling Managed Health Care Handbook, Fourth Edition, this text presents basic information on all the critical concepts of managed care; compares myths about managed care to actual facts; progresses from introductory material on the types of managed care organizations to negotiating and contracting, controlling utilization, and using data reports in medical management; illuminates the regulatory landscape, with careful attention to both federal and state law, as well as the legislative environment. Learning objectives open each chapter; useful tables and charts summarize key information at a glance; study questions encourage thoughtful analysis; includes a glossary of terms and common acronyms. Also includes Study Guide.

Genres: Health Care

883 pages, Paperback

First published December 13, 1994

Reviews

[Andrew Taylor]

Comprehensive to the point of redundancy and exhaustion. It really has full breadth of material, though it could have gone more in depth on underwriting and actuarial science as it goes so painfully in depth into so many other, less important, aspects of health care. But that's my slant as I was reading it from the perspective of a new payer organization employee, so understanding those more in depth would have been helpful. I'm giving it 4 stars because I wanted something with a lot of content, and this delivered, but the delivery of said material has quite a lot of room from improvement

[Aany Tazmin]

The content of the book is fair to good, but the writing is VERY uneven.

(Stands to reason as the chapters were written by a variety of authors - it's too bad some of them are clearly not actually writers.)

Also, wouldn't you think an editor would be a good idea?

Check out some lovely examples of how not to open your chapter:

"To manage successfully a managed care organization or payer organization, the value financial managers provide their organizations starts with their ability to interact with the operational and medical managers, to manage changes in the regulatory environment, and gather timely information to facilitate communication of financial results to the organization and its constituencies to react appropriately to sustain or exceed financial goals...

The focus of this chapter is a review of the components of the financial statements of a payer, key information and the operational procedures that the financial manager will need and rely upon, addresses typical problems that occur in gathering information and provides insight into the challenge of the integrity of information."

[Chris]

Excellent comprehensive overview of the complex acronym-cluttered landscape of managed care. Like the "Handbook of Managed Care" by the same author, but with a few chapters omitted.