Insurance coverage, reimbursement policy, and hospital care for the seriously mentally ill.
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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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The emergence of managed care creates the need for a new paradigm of risk management because of its emphasis on comprehensive services and prospective payment. Information systems, contracts and pricing, utilization management, and outcome research are key elements in devising the new paradigm.
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In the following excerpt from Dealing Direct: A Strategy for Business-Provider Partnerships, published in February by American Hospital Publishing, authors Gee and Fine discuss the right and wrong reasons for considering one of health care's most talked about new relationships.
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This paper provides an international overview of trends and elements of quality services provision in hospitals. The factors reviewed are hospital accreditation, government quality intervention, resource review, clinical procedure standardisation, patient education, high technology, financial mechanisms, risk management and evidence based medicine as relates to quality.
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Despite noble efforts all around, the early experience of a Providence, RI, health plan illustrates the difficulties in managing physician-driven programs based on percent-of-premium contracts.
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