Managed Care in the Inner City: The Uncertain Promise for Providers, Plans, and Communities

ISBN-13: 9780787946234 / Angielski / Twarda / 1999 / 224 str.

Dennis Andrulis; Betsy Carrier; Betsy Carrier

Opis

Managed Care in the Inner City presents a well-documented and candid look at how the managed care revolution has affected low-income and other vulnerable populations who live in inner cities. This ground-breaking book offers a thorough review of the drastic changes to the way health care is delivered in America's cities and presents sensible recommendations for creating programs that will satisfy public health agendas and also succeed from a policy and health care management perspective. Managed Care in the Inner City proposes to draw on the combined strengths of traditional providers and managed care to create a new paradigm of health care delivery for our inner cities.

Recenzje

"Managed care is a two–edged sword for vulnerable residents of the inner city and the providers that serve them. Managed Care in the Inner City provides a balanced and scholarly analysis of the potential of managed care concepts for Medicaid patients and the uninsured. This book should be read by policymakers at the local, state, and national levels and by providers in public hospitals and community health centers." (Ron J. Anderson, president and CEO, Parkland Health & Hospital System)

"If we think of managed care as representing a kind of global warming for indigent–care eco–systems, then our urban health systems are indeed among the most Andangered. This timely book provides us with valuable information and insight with which to understand the nature and extent of jeopardy urban health care providers are facing. In addition to providing a candid and thoughtful diagnosis, the authors go much further by identifying some of the concrete strategies and tactics being employed for survival in this environment and posing some critical policy questions that simply cannot be avoided." (Robert Hurley, associate professor, Medical College of Virginia)

"In this book Dennis Andrulis and Betsy Carrier examine the claims made on behalf of managed care and pose unsettling questions as to whether this new cure will really work or only make matters worse for inner–city residents. The authors, who come from the public–hospital sector, are measured and fair in the treatment of their subject." (Health Affairs)

Spis treści

Tables and Figures.

Preface.

Acknowledgments.

The Authors.

Chapter 1: Managed Care and the Ecology of the Inner City.

The Inner City Environment.

Access to the Health System.

Chapter 2: Managed Care, the Safety Net, and Inner City Residents.

Managed Care Organizations: Benefits and Concerns for the Inner City.

Managed Care Respond to Inner City Populations and Their Health Care Needs.

Safety Net Providers, Managed Care and Vulnerable Populations.

Chapter 3: Implementing Managed Care in the Inner City.

Community Health and Public Health Issues.

Physicians and Allied Health Professionals.

The Traditional Providers of Care in the Inner City and Their Integration with Managed Care.

Chapter 4: Integrating Urban Teaching Hospitals into Managed Care.

Old Questions, New Issues for Urban Teaching Hospitals and Their Medical Schools.

Urban Teaching Hospitals and Managed Care: Results from a National Survey.

Chapter 5: Financing Managed Care for Urban Populations.

Capitation Rates, Risk Adjustment, and Adverse Selection.

The Challenges of Attaining Stability in Enrollment.

The Special Circumstances of the Uninsured.

The Threat and the Opportunity for Inner City Safety Net Hospitals.

O autorze

DENNIS P. ANDRULIS is director of the Office of Urban Populations at the New York Academy of Medicine. He is a contributing editor to the American Journal of Medicine and a founding board member of the American International Health Alliance, which creates health care partnerships with U.S. and Central and Eastern European providers of health care. He has published extensively on a broad range of health policy issues. Andrulis is former president and CEO of the National Public Health and Hospital Institute. BETSY CARRIER is vice president for managed care at the National Association of Public Hospitals & Health Systems and has worked in health care management for over 20 years. She has extensive experience in developing managed care plans and case management programs for individuals covered by both Medicaid and commercial insurance.

Blurb

Managed Care in the Inner City presents a well–documented and candid look at how the managed care revolution has affected low–income and other vulnerable populations who live in inner cities. This groundbreaking book offers a thorough review of the drastic changes to the way health care is delivered in America′s cities and presents sensible recommAndations for creating programs that will satisfy public health agAndas and also succeed from a policy and health care management perspective.