Dissertations / Theses: 'Managed care health insurance'

1

Magner, MaryBeth. "The Effects of Managed Care on the Quality of Dental Hygiene Care." TopSCHOLAR®, 1998. http://digitalcommons.wku.edu/theses/344.

Full text

Abstract:

Managed care has become a prominent mechanism for insuring dental care. Empirical research suggests that managed dental plans provide lower quality care to patients. However, few studies have specifically addressed the effects of managed care on the quality of dental hygiene care. Thus, in this study the researcher examines whether dental hygienists deliver a lower level of treatment to managed care patients than to those who are not subject to managed care. Questionnaire data were gathered from 193 members of the American Dental Hygienists' Association residing in the Chicago area. The primary independent variable, managed care, was measured with an item that asked the respondents to indicate the percentage of patients they treat that are insured by a managed dental plan. The questionnaire also contained items that measured the frequency in which the respondents perform 23 tasks that are indicators of quality of dental hygiene care. Principal components factor analysis of these 23 items yielded the study's two dependent variables: periodontal procedures and appointment time. Regression analysis of the data revealed a significant negative relationship between managed care and appointment time. This relationship may be attributable to an economic incentive on the part of dentist-employers who control the amount of time scheduled for dental hygienists' patients. Dentist-employers may reduce the time available for managed care patients in order to allow longer appointments for more profitable fee-for-service patients. The study results did not support the notion that managed care affects the extent to which dental hygienists perform periodontal procedures. These mixed results suggest that future research should examine the relationships between managed care and other aspects of quality of dental hygiene care not addressed in the current study.

APA, Harvard, Vancouver, ISO, and other styles

2

Čížová, Ludmila. "Problematika řízené péče (managed care)." Master's thesis, Vysoká škola ekonomická v Praze, 2008. http://www.nusl.cz/ntk/nusl-10176.

Full text

Abstract:

The main theme of the thesis is managed care system description and definition. The first part is focused on managed care history, development in this system, and types of organizations providing this medical and hospital services. There is also chapter concerned with problems of resource management and managed care quality. The next chapter describes medical and health services and managed care in the USA, the only country offering these services in free mareket economy. For comparison in the next chapter there are presented someEuropean states, which try to introduce managed care as a tool for reduction of redundant and duplicate health services costs, include Czech Republic. At the conclusion, the comparison of some economic indicator of medical and health services among some European contries and the USA has been done.

APA, Harvard, Vancouver, ISO, and other styles

3

Brudevold, Christine. "Assessment of capitated contract medicine arrangements in Hong Kong : an example of financial incentives and managed care in an unregulated environment /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B20906791.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

Stein, Bradley D. "Drug and alcohol treatment services among privately insured individuals in managed behavioral health care." Santa Monica, CA : RAND, 2003. http://www.rand.org/publications/RGSD/RGSD170/RGSD170.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Yang, Jie. "Incentives of Managed Care Insurance and Treatment Choices in Low-Risk Primary Cesarean Delivery." Thesis, Wayne State University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10929029.

Full text

Abstract:

In response to climbing health care costs in the United States, many insurers and policy makers would like to eliminate waste in healthcare by steering spending toward the most cost-effective treatments. Obstacles to achieving this goal include identifying specific medical settings where overuse occurs, and then developing strategies to prevent overuse without harming patient welfare. My study examined childbirth, the number one reason for hospitalization in the US, where the overuse of medical resources primarily takes the form of nonmedically indicated cesarean deliveries.

The financial tools (physician payment differential and patient’s cost sharing) and other tools (utilization management, physician profiling, and practice guidelines) of managed care insurance create varied incentives that could affect behaviors of physicians and patients. Using data from the MarketScan commercial database, I proved that in a fee-for-service setting, physician’s financial incentives (physician payment differential) and patient’s financial disincentive (patient’s cost-sharing) affect treatment choices on childbirth delivery method, and other incentives from managed care insurance have little effect. My study also found that more restrictive nonfinancial tools in non-capitated HMOs which are expected to reduce the use of cesarean sections turn out to have little effect, while lower cost-sharing in non-capitated HMOs leads to more use of cesareans. It could provide two health policy implications: (1) health plans with generous benefits may need more restrictions and effective regulations aimed at cost control, and (2) raising patients cost-sharing may prove effective for managing medical expenses. Finally, a “What if” analysis sheds light on the likely effectiveness of various changes in managed care insurance design intended to reduce low-risk primary cesarean deliveries.

APA, Harvard, Vancouver, ISO, and other styles

6

Schiffel, Ottalee. "The usefulness of assurance services related to nonfinancial performance measures in the selection of healthcare insurance providers /." free to MU campus, to others for purchase, 2003. http://wwwlib.umi.com/cr/mo/fullcit?p3115589.

Full text

APA, Harvard, Vancouver, ISO, and other styles

7

Waterstraat, Frank Riegle Rodney P. "Adapting the quality function deployment model to health plan design." Normal, Ill. Illinois State University, 2001. http://wwwlib.umi.com/cr/ilstu/fullcit?p3064505.

Full text

Abstract:

Thesis (Ph. D.)--Illinois State University, 2001.
Title from title page screen, viewed March 10, 2006. Dissertation Committee: Rodney P. Riegle (chair), J. Christopher Eisele, George Padavil, John H. Bantham, Thomas J. Bierma. Includes bibliographical references (leaves 124-128) and abstract. Also available in print.

APA, Harvard, Vancouver, ISO, and other styles

8

Richards, Erika Kristin McKeithan. "An analysis of the effect of managed care implementation of prescription drug utilization by Texas Medicaid clients." Access restricted to users with UT Austin EID Full text (PDF) from UMI/Dissertation Abstracts International, 2001. http://wwwlib.umi.com/cr/utexas/fullcit?p3035965.

Full text

APA, Harvard, Vancouver, ISO, and other styles

9

Carter-Michaelson, Faith. "An exploratory study of San Bernardino County employees' knowledge about the limitations and provisions of their managed health care plans." CSUSB ScholarWorks, 1999. https://scholarworks.lib.csusb.edu/etd-project/1793.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Brudevold, Christine. "Assessment of capitated contract medicine arrangements in Hong Kong: an example of financial incentives andmanaged care in an unregulated environment." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31238130.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

Bello, Nathalie Duque. "Balancing Act| Successfully Combining Creativity and Accountability in the Practice of Marriage and Family Therapy." Thesis, Nova Southeastern University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3721959.

Full text

Abstract:

The conditions that allowed early MFTs the freedom to creatively explore different interventions and theories of change are no longer available in today’s mental health care system. Although there are many benefits to the structure of managed behavioral healthcare organizations, a thorough review of the literature demonstrates that many therapists working in managed care agencies struggle with maintaining their theoretical creativity, claiming third-party payers’ service requirements and paperwork a barrier to their creativity. A phenomenological transcendental research method was utilized to understand the phenomenon of successfully combining creativity and accountability in the practice of marriage and family therapy from the perspective of six creative MFTs who have effectively incorporated creative therapeutic techniques into their work, while adhering to the structured requirements of managed care.

The findings and themes of the study were organized into two categories. The themes in the Textural / Content Category (description and purpose of therapeutic creativity at a managed care agency) are: (1) Creatively combining the needs of the clients, the different professional entities, insurance companies and you as a therapist, (2) Translating post-modern information into the medical model language that meets the third-party payers’ requirements, (3) Completing documentation with clients, (4) Incorporating technique from a range of therapy models, (5) Keeping clients engaged through a variety of resources and activities, and (6) Utilizing metaphors and themes to uncover patterns of relational dynamics and behaviors. The themes in the Structural / Supportive Conditions Category (factors that allow the balance of creativity and accountability to occur) are: (1) Systemic understanding of how the therapeutic and business systems of managed behavioral healthcare interact together, (2) Having a supportive network of colleagues, (2a) Supportive group of coworkers within the job setting, (2b) Supportive network of MFT colleagues outside of the work setting, (3) Desire to make a difference in peoples’ lives, (4) Continuous education on all aspects of the mental health field, (5) Employers’ support of creative therapy, (6) Self-reflection, (7) Self-care, and (8) Organization and time management.

APA, Harvard, Vancouver, ISO, and other styles

12

Donato, Francis A. "Reforming health care through managed care." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.

Full text

Abstract:

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.
Source: Masters Abstracts International, Volume: 45-06, page: 2939. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 91-92).

APA, Harvard, Vancouver, ISO, and other styles

13

Wallace, Jacob. "How does managed care manage care? Evidence from public insurance." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493322.

Full text

Abstract:

In the United States, the fraction of individuals with public insurance is growing and the policies and markets that serve them are changing. Over two-thirds of Medicaid recipients are now enrolled in managed care organizations (MCOs), but little is known about how these plans operate. To study this market, I use data from New York Medicaid where managed care recipients are randomly assigned to plans. In chapter one, I estimate how physician and hospital networks impact health care use and spending. In chapter two, I study how production and selection vary across the managed care plans participating in New York Medicaid. Finally, in the third chapter, I turn to the Medicare program and examine how health care use and spending change at age 65 as adults switch from private to public coverage. Taken together, my dissertation chapters provide new perspective on how differences within public programs and between public and private programs, impact consumers.
Health Policy

APA, Harvard, Vancouver, ISO, and other styles

14

Abramson, Beth S. "How Managed Behavioral Health Care Impacts Psychotherapeutic Practices." Antioch University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1347310977.

Full text

APA, Harvard, Vancouver, ISO, and other styles

15

Huston, Annette L. "Carilion: A Corporate System of Managed Health Care." Diss., Virginia Tech, 2001. http://hdl.handle.net/10919/29798.

Full text

Abstract:

In the late 20th century, the management of care came under the control of large health care conglomerates, like the Carilion Health System in Roanoke, Virginia. This study examines the evolution of Carilion from its beginning in 1988 to the present and analyzes Carilion as a complex system by using analytical tools drawn from a variety of STS scholars. Carilion's mission began with its hospitals. From 1954-1988, Carilion's predecessor, the Roanoke Hospital Association, developed a network for delivering care, training programs and management to small community hospitals throughout southwest Virginia. In 1988, the Roanoke Hospital Association was officially renamed the Carilion Health System. In its initial phase, 1988-1992, Carilion expanded its hospital network into as many communities as possible. The thesis of this work is that Carilion and communities came together to see if they could build a corporation to manage care and, at the same time, maintain local traditions of care. From 1992-1996, Carilion transformed itself from a hospital organization to a health care system and finally to a managed care system in order to compete with rival Columbia/HCA. This transformation required the creation of a physician management company and a health plans division. In 1995, Carilion's administrators began a reengineering program which redefined services and strategies for corporate growth. This included construction of a state-of-the-art facility situated between two competing Columbia/HCA hospitals in the New River Valley. In 1998-2000, Carilion engaged in a massive advertising blitz to garner additional market share from Columbia/HCA. Carilion's marketing strategies show that health care has changed dramatically under a business model, in spite of corporate America's assurances that it would not. This study gives voice to health care workers who describe exactly how their experiences have changed since corporations, such as Carilion, began managing their work. Drawing on interviews with Carilion physicians, hospital administrators, board members and medical staffs, the day-to-day activities taking place within hospitals and physician practices comes to life. The narrations describe how difficult it is for groups working within Carilion's facilities to carry out Carilion's growth strategies while at the same time maintaining communities' traditions of care. Since 1999, Carilion moved in three new directions: the creation of the Carilion Biomedical Institute incorporating biotechnology and biomedicine; the institution of a hospital partial-ownership program, which meant Carilion did not have to assume full ownership and expenses of some facilities; and the installation of an electronic medical records system in physician practices to manage patients' data, physicians' costs and physicians' productivity. These new directions illustrate how Carilion envisions a different paradigm of care delivery. While the study addresses how Carilion became a managed care organization, this work represents foremost an analysis of system building in America today. Like most corporate systems, Carilion exemplifies a mix of social, economic and technological components that have been assembled to form a corporate entity. This work explains how corporate systems come to manage traditions, values and resources within communities and for communities.
Ph. D.

APA, Harvard, Vancouver, ISO, and other styles

16

Bornman, Magda. "Digital media as communication tools for health promotion in managed health care." Pretoria : [s.n.], 2000. http://upetd.up.ac.za/thesis/available/etd-07132006-105048/.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Blanton, Sandra. "Justice in Health Care Access Measuring Attitudes of Health Care Professionals." TopSCHOLAR®, 2000. http://digitalcommons.wku.edu/theses/714.

Full text

Abstract:

To measure attitudes toward justice in access to health care services in managed care plans in a convenience sample of medical professionals at Clark Memorial Hospital in Jeffersonville, Indiana. Methods. A sixteen item, self-administered instrument based on Morreim's four concepts of justice in health care access was administered to 147 health care professionals, representing physicians, allied health, and hospital administration. SPSS was used to analyze the results. Results. The attitudes of the respondents were negative toward managed care. They did not feel that managed care had been a positive development in the United States or that managed care had improved access to preventive care or improved primary care. On the survey instrument, respondents scored highest on the scale measuring fairness to individual patients. Conclusion. In a convenience sample of health care professionals at Clark Memorial Hospital in Jeffersonville, Indiana, equity in distributing access to health care among individual patient needs was found to more closely meet their expectations of justice in health care access. There were no differences found across occupational groups in their responses to the two scales. There were differences in attitudes toward managed care among occupational groups.

APA, Harvard, Vancouver, ISO, and other styles

18

McCabe, Helen, and res cand@acu edu au. "The Ethical Implications of Incorporating Managed Care into the Australian Health Care Context." Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp48.29082005.

Full text

Abstract:

AIMS Managed care is a market model of health care distribution, aspects of which are being incorporated into the Australian health care environment. Justifications for adopting managed care lie in purported claims to higher levels of efficiency and greater ‘consumer’ choice. The purpose of this research, then, is to determine the ethical implications of adapting this particular administrative model to Australia’s health care system. In general, it is intended to provide ethical guidance for health care administrators and policy-makers, health care practitioners, patients and the wider community. SCOPE Managed care emerges as a product of the contemporary, neo-liberal market with which it is inextricably linked. In order to understand the nature of this concept, then, this research necessarily includes a limited account of the nature of the market in which managed care is situated and disseminated. While a more detailed examination of the neo-liberal market is worthy of a thesis in itself, this project attends, less ambitiously, to two general concerns. Firstly, against a background of various histories of health care distribution, it assesses the market’s propensity for upholding the moral requirements of health care distributive decision-making. This aspect of the analysis is informed by a framework for health care morality the construction of which accompanies an inquiry into the moral nature of health care, including a deliberation about rights-claims to health care and the proper means of its distribution. Secondly, by way of offering a precautionary tale, it examines the organisational structures and regulations by which its expansionary ambitions are promoted and realised. CONCLUSIONS As a market solution to the problem of administering health care resources, the pursuit of cost-control, if not actual profit, becomes the primary objective of health care activity under managed care. Hence, the moral purposes of health care provision, as pursued within the therapeutic relationship and expressed through the social provision of health care, are displaced by the economic purposes of the ‘free’ market. Accordingly, the integrity of both health care practitioners and communities is corrupted. At the same time, it is demonstrated that the claims of managed care proponents to higher levels of efficiency are largely unfounded; indeed, under managed care, health care costs have continued to rise. At the same time, levels of access to health care have deteriorated. These adverse outcomes of managed care are borne, most particularly, by poorer members of communities. Further, contrary to the claims of its proponents, choice as to the availability and kinds of health care services is diminished. Moreover, the competitive market in which managed care is situated has given rise to a plethora of bankruptcies, mergers and alliances in the United States where the market is now characterised by oligopoly and monopoly providers. In this way, a viable market in health care is largely disproved. Nonetheless, when protected within a non-market context and subject to the requirements of justice, a limited number of managed care techniques can assist Australia’s efforts to conserve the resources of health care. However, any more robust adoption of this concept would be ethically indefensible.

APA, Harvard, Vancouver, ISO, and other styles

19

Fike, Verinda Jean Esther. "Health insurance and health care access in China." CONNECT TO ELECTRONIC THESIS, 2008. http://dspace.wrlc.org/handle/1961/5527.

Full text

APA, Harvard, Vancouver, ISO, and other styles

20

Webb, Janet Marie. "Information about primary care physicians considered most useful by managed health care consumers." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1370.

Full text

APA, Harvard, Vancouver, ISO, and other styles

21

Hasson, James M. "The ramifications of managed care in the behavioral health care setting in Berks County." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1997. http://www.kutztown.edu/library/services/remote_access.asp.

Full text

Abstract:

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1997.
Source: Masters Abstracts International, Volume: 45-06, page: 2943. Abstract precedes thesis as 1 preliminary leaf. Typescript. Includes bibliographical references (leaves 66-67).

APA, Harvard, Vancouver, ISO, and other styles

22

Fleming, Elaine. "Provider Networks in Health Care Markets." Thesis, Boston College, 2003. http://hdl.handle.net/2345/1807.

Full text

Abstract:

Thesis advisor: Peter Gottschalk
Thesis advisor: Thomas McGuire
Thesis advisor: Donald Cox
Does managed care send expectant mothers to hospitals they would choose even if their choice of hospital was not limited? I find that Medicaid managed care patients are redirected to hospitals that enrollees of more generous insurance payers with the same personal characteristics do not go to. However, Medicare managed care enrollees do not face an increased risk of having a cesarean delivery at the hospital they attend, which is interpreted as evidence that they are redirected to high quality hospitals
Thesis (PhD) — Boston College, 2003
Submitted to: Boston College. Graduate School of Arts and Sciences
Discipline: Economics

APA, Harvard, Vancouver, ISO, and other styles

23

Walker, Benjamin F. "The advent of managed care an examination of the impact on behavioral human service delivery /." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 2006. http://www.kutztown.edu/library/services/remote_access.asp.

Full text

Abstract:

Thesis (M.P.A. )--Kutztown University of Pennsylvania, 2006.
Source: Masters Abstracts International, Volume: 45-06, page: 2963. Typescript. Abstract precedes thesis as 2 leaves. Includes bibliographical references (leaves 77-84).

APA, Harvard, Vancouver, ISO, and other styles

24

Liu, Fei. "Three essays on health insurance and health care consumption." [Bloomington, Ind.] : Indiana University, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3243799.

Full text

Abstract:

Thesis (Ph.D.)--Indiana University, Dept. of Economics, 2007.
Title from PDF t.p. (viewed Nov. 18, 2008). Source: Dissertation Abstracts International, Volume: 67-12, Section: A, page: 4627. Adviser: Pravin K. Trivedi.

APA, Harvard, Vancouver, ISO, and other styles

25

Moe, Christine. "Medicare Managed Care Penetration and Prevalence of Older Adult Disability." VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1663.

Full text

Abstract:

OBJECTIVE: To investigate the relationship between Medicare Managed Care (MMC) penetration and percentage of disability in older adults (individuals age 65 and older). Considering disability as an indicator of one or more unsuccessfully managed chronic diseases, this study investigates the assumption that managed care improves coordination of care, as well as access to preventive care. If managed care’s mandate is being met, then it should be evidenced in decreased prevalence of older adult disability. METHOD: Taking an ecological approach, this study used data from the Agency for Healthcare Research and Quality (AHRQ, 2003) to compare the percentage of older adult disability in counties from 30 states and the District of Columbia with high and low MMC penetration. Covariates representing various aspects of community context were introduced into a final multivariate linear regression to examine whether MMC penetration was a significant predictor of countywide percent of older adult disability. RESULTS: While MMC penetration was a significant predictor of prevalence of older adult disability in a bivariate analysis (r=-0.197, p < .001), it lost its significance in the final multivariate model. CONCLUSION: While this study does not demonstrate a relationship between MMC penetration and prevalence of older adult disability, it is possible that MMC, once fully implemented under the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, could lead to reduced prevalence of disability.

APA, Harvard, Vancouver, ISO, and other styles

26

Solis, Beatriz Maria. "Medi-Cal managed care enrollees diverse experiences and perceptions about the health care system /." Diss., Restricted to subscribing institutions, 2007. http://proquest.umi.com/pqdweb?did=1464129111&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Joshi, Ashish Vikas. "HEALTH CARE UTILIZATION AND COSTS IN OHIO MEDICAID: MANAGED CARE VERSUS FEE-FOR-SERVICE." University of Cincinnati / OhioLINK, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=ucin976036967.

Full text

APA, Harvard, Vancouver, ISO, and other styles

28

Abughosh, Susan M. "Drug benefit plans for elderly under managed care and utilization of lipid lowering agents /." View online ; access limited to URI, 2003. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3112111.

Full text

APA, Harvard, Vancouver, ISO, and other styles

29

Besley, T. J. "The theory of health risk and health insurance." Thesis, University of Oxford, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.384692.

Full text

APA, Harvard, Vancouver, ISO, and other styles

30

So'Brien, van Putten Juliette M. "Diabetes self-management (DSM) education within managed care organizations in Ohio /." The Ohio State University, 1998. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487949508369574.

Full text

APA, Harvard, Vancouver, ISO, and other styles

31

Flood, Colleen M. "Comparing models of health care reform, internal markets and managed competition." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0003/NQ33923.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

32

Höfter, Ricardo Andres Henriquez. "Preferred providers, health insurance and primary health care in Chile." Thesis, Queen Mary, University of London, 2006. http://qmro.qmul.ac.uk/xmlui/handle/123456789/1772.

Full text

Abstract:

Reforms in the early 1980s created Chile's mixed system of health care provision and finance. Since then Chileans have had to choose between a statesubsidised public health insurance system or the private health plans offered by several insurance companies. In the public system, users may be restricted to the public facility network, with no choice of doctor or medical centre, or they may opt for a free choice mode (preferred providers), which lets them choose both doctor and place of attention. Private insurance providers offer a wide variety of health plans, giving the customer a reasonable range of care options. Although this public-private mix has now been operating for more than 20 years, there has been no empirical study of the factors determining the choice of the preferred providers' mode by public beneficiaries. Likewise, few studies have looked at the determinants in the choice between public and private insurance, and the relationship between the latter choice and the use of health services. The first two empirical chapters of this thesis look at the determinants of these sources of choice, using different econometric tools: the choice of preferred providers is examined using a logit model; the analysis into the choice between public and private insurance uses a probit model; and the impact of holding private insurance as a factor in determining use of health services is estimated through a two-stage tobit model. A further significant aspect of the reforms of the '80s was the process of decentralisation for primary health care provision. Since then a substantial part of preventive health care and promotion occurs locally, and among these services children's health checks are an important policy objective. To encourage attendance parents are given free food supplements if they keep to the timetable for their child's check-ups. However these free food handouts partially account for attendance at the check-ups. Thus the final empirical chapter of the thesis uses a probabilistic model to look at the monetary and non-monetary factors that lead parents to request health checks for their children.

APA, Harvard, Vancouver, ISO, and other styles

33

Barbaccio, Lisa R. "Consumerism in Health Insurance: Understanding Literacy in Health Insurance Purchasing and Benefit Consumption." Diss., Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/540834.

Full text

Abstract:

Business Administration/Interdisciplinary
D.B.A.
The growth rate and percent of GDP spend on health care has brought necessary attention to discussions on cost and quality within the health industry. This research posits that in order to tackle issues within these cost and quality-conscious discussions, consumers require increased literacy in the health insurance shopping and utilization processes. Health insurance literacy is relatively new terminology. In regard to consumer literacy measures in purchasing, the findings in Chapter 1 demonstrate that studies on health insurance literacy are inconsistent, with no consensus on which metrics are most appropriate to measure health insurance literacy. While there is a generally agreed upon definition of health insurance literacy, there is currently no standard scale to determine one’s literacy level. Additionally, literacy, in a broader construct, can assist consumers in making better informed choices about how to engage with and manage their health insurance. One particular example of a poor utilization habit is the use of the Emergency Room (ER) for non-emergent conditions. The findings in Chapter 2 demonstrate that educated consumers can be influenced to choose alternative sites for ER care. This research suggests that taking measures to advance health insurance literacy can improve both shopping and utilization behavior and, in turn, positively impact health care costs and efficiencies. The conclusion of this research theorizes on the best approach to influence literacy in health insurance; ultimately furthering the body of research that moves toward a more efficient, effective, and literate health insurance industry.
Temple University--Theses

APA, Harvard, Vancouver, ISO, and other styles

34

Riffe, Holly Ann. "The Changing Nature of Clinical Social Work: Managed Care and Job Satisfaction /." The Ohio State University, 1995. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487928649987234.

Full text

APA, Harvard, Vancouver, ISO, and other styles

35

Grimes, Bonnie. "Veterans with Chronic Back Pain Managed in Primary Care: Patient Aligned Care Team." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4726.

Full text

Abstract:

Chronic pain affects approximately 100 million adults in the United States annually, and costs exceeding $635 billion. Pain is the most common complaint in primary care, and chronic pain accounts for up to 16% of emergency room visits. Additionally, chronic pain accounts for 25% of missed workdays annually. Veterans are particularly vulnerable to chronic pain and have an increased incidence of chronic non-cancer pain. Chronic pain for veterans cost the Veterans Administration (VA) about $385 billion each year. This project evaluated the Patient Aligned Care Team (PACT) model to manage chronic lower back pain (CLBP) at a VA primary care center. The framework that guided the project was the theory of planned change and the chronic care model. A retrospective electronic chart review of demographic and pain management data was collected from a convenience sample of veterans (20 women, 20 men) with a history of CLBP managed by the primary care center for at least 1 year prior to and one year after the PACT model was implemented. Overall, the paired-samples t-test to was not statistically significant for improvements in veteran reported pain scores over time. However, there was a significant interaction between time and gender that indicates changes over time significantly differed because of gender. In addition, descriptively the mean pain levels were initially higher for men as compared to women, and these levels increased sharply for females over time while the men decreased. This project contributes positively to social change for veterans as the findings indicate an important gender difference in patient reported pain scores over time. There needs to be additional investigation to understand the etiology of the gender difference in the pain outcomes for CLBP.

APA, Harvard, Vancouver, ISO, and other styles

36

Moore, Shana L. "Is There a Trade-off? Infant Health Outcomes and Managed Care Competition." UKnowledge, 2016. http://uknowledge.uky.edu/msppa_etds/16.

Full text

Abstract:

This study offers insights into the impact of competition among Managed Care organizations (MCOs) on infant birthing charges and birth outcomes. Kentucky provides one of the nation’s first case studies to determine successes and failures of Medicaid MCOs, and by doing so, provides a prediction of the impact of Patient Protection Affordable Care Act (PPACA) competition on healthcare costs and birth outcomes. An analysis of a natural policy experiment in the state of Kentucky reveals that infants insured by a Medicaid MCO stay longer in hospitals, are less healthy, and cost more than those insured under Traditional Medicaid prior to a policy change. Utilizing a difference-in-difference-in-difference (DDD) estimation, this study found initial evidence in a competitive MCO environment of Traditional Medicaid average birth charges substantially more than births under a Medicaid MCO, while outcomes also revealed the incidence of normal delivery increased almost identical to that of private insurance. However, after a short time, average birth charges for infants born under Medicaid MCO climb higher than other payer-types and infant health begins to decline. Outcomes of this study signal that Managed Care infants are actually less healthy and cost substantially more than anticipated but it is possible that these outcomes can be attributed to insurance selection.

APA, Harvard, Vancouver, ISO, and other styles

37

Inkelas, Moira. "Incentives in a specialty care carve-out." Santa Monica, CA : RAND Graduate School, 2001. http://catalog.hathitrust.org/api/volumes/oclc/47357973.html.

Full text

APA, Harvard, Vancouver, ISO, and other styles

38

Abdelrahim, Mahgoub. "Sudan social health insurance : challenges towards universal access to health care." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/sudan-social-health-insurance-challenges-towards-universalaccess-to-health-care(cd798918-f63f-4d3d-8019-2229c89ca3dc).html.

Full text

Abstract:

To achieve effective access to health care, countries have adopted various policies to improve the populations' legitimate right to obtain health care when needed. Social health insurance has been proposed by the WHO as a means to securing sustainable access to health care particularly for developing countries. As one of the developing countries, Sudan launched SHI in 1994; however, population coverage still does not exceed 28.7% of the total population. Given the complexities of access to health care, the issue of achieving universal access by the adoption of SHI is faced with various challenges. Recognising the factors that influence an individual's decision to access health care ultimately adds to the success of the policy intervention to meet the stated goals. In addition, understanding and recognising the households' perspectives and motives to affiliate with SHI is critical to the success of the devised policy initiative. Therefore, this thesis examines the determinants of both access to health care and enrolment in social health insurance in Sudan. It also examines the implication of the adoption of social health insurance as a means to improving the population's access to health care. To achieve the stated objectives, the thesis adopted a quantitative cross-sectional study design involving a household survey in Kassala State in Sudan. The household survey (n=560) collected information from 280 voluntary insured households as well as 280 uninsured households living in rural and urban areas of Kassala State. The study confirms that both access to health care and voluntary enrolment in SHI in Sudan are influenced by factors embedded in the Andersen and Penchansky models of access to health care. These factors include the head of the household's; age, place of residence, gender, health status, the number of family members, perception about the waiting time to see the doctor, perception about the staff treatment, the level of knowledge about SHI and the monthly income. The study confirms that SHI does not act directly to improve utilization of health care; instead, its effect is mediated by other factors especially income level. Thus, access to health care is not merely the function of the health insurance status of the population; however, together with empowering the household's income level, improving the supply side of the health delivery system and reducing the gender inequality SHI is more likely to improve the population's access to health care. In addition, the study proves that those who are able to pay the health insurance premium and joined the scheme, are either looking for additional value for money (e.g. getting health services at a cheap price) or escaping an escalating cost of health care resulting from personal costly health status (e.g. chronic illness). Thus, the success of improving voluntary uptake of SHI depends on adding convincing value for money, raising the people's awareness about the scheme especially female households, targeting rural residence, especially those with large family size, and otherwise adopting a compulsory enrolment policy. The thesis contributed to knowledge through the development of a single theoretical framework encompassing both the health seeking behaviour and the adequacy of the health delivery system. The theoretical framework not only studied access to healthcare but also the factors that influence enrolment in health insurance. The new conceptual framework and the thesis's policy implications are applicable to developing countries that adopt SHI and express socioeconomic characteristic and problems resembling that of Sudan. It is also worth mentioning it is the first study to evaluate the impact of Sudan SHI in terms of population access to health care.

APA, Harvard, Vancouver, ISO, and other styles

39

Norbeck, Angela J. "Health Insurance Literacy Impacts on Enrollment and Satisfaction with Health Insurance." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5387.

Full text

Abstract:

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to test hypotheses of four predictive relationships between (a) HI enrollment and HIL with HI terms; (b) marketplace enrollment and HIL with HI terms; (c) satisfaction with HI and HIL with HI access to care; and (d) satisfaction with HI and HIL with HI cost of care. Results indicated that participants with high HIL with HI terms had 4.2 times higher odds that those with low HIL to be enrolled in HI and 81% higher odds than those with low HIL to be enrolled in marketplace HI. The most significant relationship indicated that participants with high HIL with HI activities had 12.8 times higher odds than those with low HIL to have high satisfaction with access to care and 8.8 times higher odds than those with low HIL participants to have high satisfaction with cost of care. The finding that low HIL is associated with lower enrollment and lower satisfaction with HI has implications for social change. Policymakers may have the opportunity to utilize this study to promote policies that promote higher HIL, which may lead to increased HI enrollment and improved satisfaction with HI selection.

APA, Harvard, Vancouver, ISO, and other styles

40

Coetzee, Renier. "An analysis of the usage of antibiotics in the private health care sector : a managed health care approach / Renier Coetzee." Thesis, North-West University, 2004. http://hdl.handle.net/10394/91.

Full text

Abstract:

The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. However, health care expenditure is a great cause for concern and many nations around the world struggle to contain rising health care costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR) and disease management have emerged as control tools to ensure cost effective selection and use of medicine. These managed care instruments are often used to determine whether new strategies or interventions, such as the implementation of a managed medicine reference price list, are appropriate and have "value". The general objective of this study was to investigate the influences of the implementation of a managed medicine reference price list on the usage and cost of antibiotic medicine in the private health care sector of South Africa. The research design used in this study was retrospective, non-experimental and quantitative. The data used for the analysis were obtained over a two-year study period (1 May 2001 to 31 April 2003) from the central medicine claims database of Medschem&. Data was analysed according to prevalence, cost and original (innovator) or generic medicine items. For the purpose of this study antibiotics referred to beta-lactams (penicillins, cephalosporins and "others"), erythromycin and other macrolides, tetracyclines, sulphonamides and combinations, quinolones, chloramphenicol and aminoglycosides. The results of the empirical investigation showed the total number of medicine items claimed during the study period amounted to 49098736 medicine items having a total expenditure of R7150344897.00. There was a decrease in the prevalence of original (innovator) products during the two-year period. The prevalence of generic products increased from 25.87% to 32.47%. A total of 4092495 antibiotic medicine items were claimed with a total cost of R526309279.43 representing 7.36% (n = R7150344897.00) of all pharmaceutical products purchased during the two-year period. Original antibiotics had a prevalence of 42.32%, while generic antibiotics constituted 57.68% of all antibiotic products claimed (n = 4092495). However, original (innovator) products contributed 62.32% and generic products 37.68% to the total cost of all antibiotics claimed. It was concluded that the beta-lactam antibiotics represented 56.99% of all antibiotics claimed (n = 4092495) and contributed 52.51% to the total antibiotic expenditure (n = R526309279.43) for the two-year period. The average cost of beta-lactam items ranged between R112.88 * 69.95 and R122.18 + 81.42. The Medschema Price List (MPL) was implemented in May 2001. The aim of this reference pricing system was to allocate a ceiling price to a group of drugs, which are similar in terms of composition, clinical efficacy, safety and quality, with the ultimate goal to reduce medicine expenditure. During the year of implementation of the MPL 62.24% of beta-lactam antibiotics claimed (n = 1303464) were MPL listed. These products contributed 43.25% to the total cost of all beta-lactam antibiotics (n = R157142778.38). Medical aid companies reimbursed R61649211.86 for penicillins claimed and MPL listed. If all penicillin products were claimed at the ceiling price set by the MPL, a cost saving of 2.79% could have been achieved. Cost analysis indicated that it is possible to reduce health care costs by implementing strategies with the aim to reduce medicine cost. Further research, however, is necessary and in this regard recommendations for further research were formulated.
Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.

APA, Harvard, Vancouver, ISO, and other styles

41

Ford, Lawrence Randolph. "Exploration of Practice Managers' Decision-Making Strategies in a Managed-Care Paradigm." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3094.

Full text

Abstract:

Practice managers are facing challenging expectations when deploying a managed-care paradigm. The problem addressed in this study was a gap in knowledge regarding practice managers' decision-making strategies that affect, or could be perceived to affect, a climate of excellence with business and client relationships, primary health care, physicians, and patients in a managed-care paradigm. The purpose of the qualitative exploratory study was to explore practice managers' decision-making strategies affecting primary health care, physicians, and patients. Guided by Simon's ideology of decision-making strategies in a management environment, the overarching research question and 3 subquestions centered on how practice managers delineate their decision-making strategies and how those strategies affect primary health care, physicians, and patients. To close the gap in knowledge, the study included (a) a homogeneous purposive sampling of 14 practice managers (n = 2, pilot study; n = 12, main study) as research participants; (b) face-to-face interviews with semistructured, open-ended questions to collect data; and (c) in vivo and pattern coding during data analysis. The study results indicated a need for change agents, interactions, partnerships, and accountability in a managed-care paradigm. Managing health care is complex and practice managers will continue to be challenged. Alliances between practice managers and stakeholders are recommended to meet those challenging expectations. As a result, positive social changes may be observed in improved access to primary health care, better health care treatments, and collaborative interactions in a managed-care paradigm.

APA, Harvard, Vancouver, ISO, and other styles

42

Alex, Theodore P. "An investigation of the impact of HealthChoices managed behavioral healthcare on the Lehigh Valley." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1999. http://www.kutztown.edu/library/services/remote_access.asp.

Full text

Abstract:

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1999.
Source: Masters Abstracts International, Volume: 45-06, page: 2928. Typescript. Abstract precedes thesis as preliminary leaves iii-iv. Includes bibliographical references 122-127.

APA, Harvard, Vancouver, ISO, and other styles

43

Thompson, Jennifer W. "Insurance status, health care access, and adolescent smoking initiation." CONNECT TO ELECTRONIC THESIS, 2007. http://dspace.wrlc.org/handle/1961/4144.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

Buker, Macey. "Relationship Between Health Care Costs and Type of Insurance." Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10634995.

Full text

Abstract:

Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way ANOVAs indicated that between 2% and 9% of health care costs could be attributed to type of health insurance, a statistically significant finding. Results also supported the effectiveness of the ACA in stabilizing health care costs. The average annual rate of health care cost increase was 38.6% from 2007 until 2010, decreasing to an average annual increase of 4.3% from 2011 until 2014. Results provide important information to generate positive social change for consumers, providers, and policymakers. This includes improving decisions related to health care costs, improved understanding of the costs of health care services, increased transparency, increased patient engagement, maximizing consumer utility, facilitation of reduction of waste within the industry, and increased understanding of the impact of health policy on health care costs and efficiencies within newly created health policies. Results may also improve transparency of health care costs, which allows consumers, providers, and policymakers to take specific action to reduce health care costs, resulting in a more just and sustainable health care model.

APA, Harvard, Vancouver, ISO, and other styles

45

McCollum, Denise M. "The Structural Response and Performance of General Hospitals in a Managed Care Environment." VCU Scholars Compass, 1998. https://scholarscompass.vcu.edu/etd/4943.

Full text

Abstract:

The study purpose is to link hospital structure, represented by each hospital’s professional contingent, service mix, and inpatient capacity; and its environment, characterized by the penetration of managed care enrollees. The secondary purpose is to test the relationship between hospital structural change and subsequent hospital performance. The study employs a non-experimental panel design, with a sample of 1882 community hospitals (service type: general medical and surgical). Environmental variables are measured for the base year 1989. Hospital structural variables are measured for 1989 and 1994, with change variables computed. Performance variables are measured for 1989 and 1995, with change computed for cost measures. Hospital structural change is viewed as a dependent variable related to the environment, as well as an independent variable related to performance. Descriptive data are extracted from the American Hospital Association Annual Survey of Hospitals. Hospital cost performance data are from the Health Care Financing Administration Prospective Payment System Minimum Data Sets. Hospital mortality data for 1989 are from Medicare Hospital Mortality Information. HMO enrollment data are extracted from the Interstudy Edge and aggregated to metropolitan statistical area (MSA) level. Market competition data are from the 1989 Area Resource File. A Herﬁndahl-Hirschman index (HHI) is calculated for each hospital’s MSA. Analytical hypotheses are tested using ordinary least squares (OLS) technique. Results from Part 1 suggest that where HMO penetration was relatively high, sample hospitals tended to contain growth in their registered nurse (RN) staff between 1989 and 1994. Higher HMO penetration is also associated with more stabilization in occupancy rates, preventive services, and ambulatory workload. In contrast, market competition is associated with changes to a higher Medicare case-mix index (CMI), and increase in ambulatory visits. Results from Part 2 indicate positive associations between increased RN staff and hospital cost growth between 1989 and 1995. Hospitals which did not experience an increased CMI are similarly linked with cost growth. Alternatively, reduction in hospital bedsize is associated with more controlled growth in hospital cost per patient day. Several control variables display noteworthy associations with the variables of interest. Theoretical and management implications for community hospitals are discussed.

APA, Harvard, Vancouver, ISO, and other styles

46

Nearon, Darrell Maxwell Jr. "A study of the relationship between health care access and access barriers to behavioral health care for African Americans utilizing the managed care model." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2001. http://digitalcommons.auctr.edu/dissertations/AAI3034591.

Full text

Abstract:

Managed care has revolutionized the healthcare industry. Prior to managed care, traditional insurance companies managed the healthcare industry. These insurance firms would monitor and authorize treatment to persons enrolled with the insurance company. Health Maintenance Organizations (HMOs) began to develop methods to provide similar service as the large insurance companies at a fraction of the cost. HMOs accomplished this by selling their products directly to employer groups. This significantly reduced administrative costs that had been traditionally passed on to the consumer. Unable to financially keep pace with the HMOs, the insurance companies abandoned the health insurance arena. As managed care has grown so have the problems associated with his system. Issues involving antitrust, confidentiality, privacy, and best practices are but a few of the critical issues facing managed care. All three branches of the United States government have been involved in resolving issues pertaining to managed care. Reforms have been demanded from the system and the current political climate may force the system to reconsider the manner in which it is conducting business. Minority consumers and specifically African Americans traditionally have been discriminated against from engaging in such life activities as housing, voting, commerce, and banking, without judicial intervention. The healthcare industry is no exception. The United States Surgeon General, in his seminal report on mental health, identifies that African Americans and other minorities have been excluded from obtaining appropriate and timely healthcare. The Surgeon General's report coupled with the President's report on Healthy People 2000, identify that initiatives are needed to rectify the inequities in healthcare in healthcare service delivery. A total of fifty-two African American consumers of mental health service with a primary diagnosis of adjustment disorder were surveyed to assess their perceptions as to whether or not they have access to their behavioral health services. The Consumer Access Questionnaire was designed to gather both demographic and consumer perceptions on the accessibility and feasibility of managed care for this selected population of African Americans. In all categories surveyed on the questionnaire, the results revealed that the respondents were able to access their outpatient behavioral health provider when utilizing the managed care system. The respondents provided an overall satisfaction rate with their respective managed care plans.

APA, Harvard, Vancouver, ISO, and other styles

47

Nearon, Darrell M. "A study of the relationship between health care access and access barriers to behavioral health care for African Americans utilizing the managed care model." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2001. http://digitalcommons.auctr.edu/dissertations/3784.

Full text

Abstract:

Managed care has revolutionized the healthcare industry. Prior to managed care, traditional insurance companies managed the healthcare industry. These insurance firms would monitor and authorize treatment to persons enrolled with the insurance company. Health Maintenance Organizations (HMOs) began to develop methods to provide similar service as the large insurance companies at a fraction of the cost. HMOs accomplished this by selling their products directly to employer groups. This significantly reduced administrative costs that had been traditionally passed on to the consumer. Unable to financially keep pace with the HMOs, the insurance companies abandoned the health insurance arena. As managed care has grown so have the problems associated with his system. Issues involving antitrust, confidentiality, privacy, and best practices are but a few of the critical issues facing managed care. All three branches of the United States government have been involved in resolving issues pertaining to managed care. Reforms have been demanded from the system and the current political climate may force the system to reconsider the manner in which it is conducting business. Minority consumers and specifically African Americans traditionally have been discriminated against from engaging in such life activities as housing, voting, commerce, and banking, without judicial intervention. The healthcare industry is no exception. The United States Surgeon General, in his seminal report on mental health, identifies that African Americans and other minorities have been excluded from obtaining appropriate and timely healthcare. The Surgeon General’s report coupled with the President’s report on Healthy People 2000, identify that initiatives are needed to rectify the inequities in healthcare in healthcare service delivery. A total of fifty-two African American consumers of mental health service with a primary diagnosis of adjustment disorder were surveyed to assess their perceptions as to whether or not they have access to their behavioral health services. The Consumer Access Questionnaire was designed to gather both demographic and consumer perceptions on the accessibility and feasibility of managed care for this selected population of African Americans. In all categories surveyed on the questionnaire, the results revealed that the respondents were able to access their outpatient behavioral health provider when utilizing the managed care system. The respondents provided an overall satisfaction rate with their respective managed care plans. 2

APA, Harvard, Vancouver, ISO, and other styles

48

Webb, Matthew Aaron. "Modeling Individual Health Care Utilization." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/8832.

Full text

Abstract:

Health care represents an increasing proportion of global consumption. We discuss ways to model health care utilization on an individual basis. We present a probabilistic, generative model of utilization. Leveraging previously observed utilization levels, we learn a latent structure that can be used to accurately understand risk and make predictions. We evaluate the effectiveness of the model using data from a large population.

APA, Harvard, Vancouver, ISO, and other styles

49

Kaissi, Lana. "SOCIAL WORK PERSPECTIVES ON THE CONSTRAINTS OF MANAGED CARE AND MENTAL HEALTH TREATMENT." CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/869.

Full text

Abstract:

Approximately 46.6 million adults in the United States live with a mental illness as of 2017. Therefore, managed care being the system that facilitates access to mental health treatment needs to be addressed. Managed care (such as healthcare plans) seeks to facilitate healthcare service delivery by providing direction and guidance to utilization and prevention of services. The purpose of this qualitative study is to explore social work perspectives on the constraints of managed care as it impacts access to mental health treatment. This study conducted qualitative interviews through a non-random sample of professional colleagues of social workers in the in the manage care field. This study found five emerging themes including long wait times, lack of providers (to provide timely, effective mental health treatment), over diagnosing to justify services, profit-driven service delivery, and managed care not aligning with social work values. The implications of this study urge the need for accountability and consistency through policy change and reform.

APA, Harvard, Vancouver, ISO, and other styles

50

Angelotta, John Walton. "Clinical social workers' involvement in and adoption of managed mental health care technology." Case Western Reserve University School of Graduate Studies / OhioLINK, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=case1057687689.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Dissertations / Theses on the topic 'Managed care health insurance'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles