Managed care operations and plan design

Article Abstract:

The first generation of managed care plans have yielded a rich experience that could be used in the evaluation of health care providers and in designing the managed care plans of companies. Feedback from plan participants, the operational capabilities of managed care providers, plan election patterns, cost and utilization results and the strategic fit of managed care providers with the company's goals are some of the more important considerations in designing a managed care plan.

author: Havlin, Linda J.
Planning

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Access to services: what are the real needs?

Article Abstract:

Employers' decision to implement managed care plans often hinges on their perception of adequate accessibility of plan participants to managed care services. Access is often equated with geographic access, with participants living within a standard distance of eight to 10 miles from a primary care provider and 15 miles from a hospital. Criteria other than geographic distance which may be used to assess adequate accessibility to managed care services are presented.

author: Havlin, Linda J., Bird, Beth Ann
Management

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The customer satisfaction factor: the value of conducting employee evaluations of managed care networks

Article Abstract:

Methods to assess the quality of care and services that employees get from managed care networks have become more necessary as more and more employers implement managed care plans to minimize health care costs. Evaluation of managed care services by plan employee participants has proven to be an effective tool for assessing quality-of-care issues in managed care. The intelligent use of data from such evaluations could lead to better health care management.

author: Moses, John D.

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subjects list: Evaluation, Medical care, Managed care plans (Medical care), Employee benefits
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