CareWorks Managed Care Dictionary 40 pages of terms!
Managed Care Terms and Definitions Managed Care Resources, Inc. 20 pages of terms! 01/26/05
Guide to Managed Care Contains 3 page section on Healthspeak: The
Of Managed Care. 01/26/05
Your Guide to Managed Care The ABCs of HMOs. Answers to the most commonly asked questions. How does managed care differ from traditional insurance? What are the differences between HMOs, PPOs and POSs? 01/26/05
Front Line: Primary Care Physicians Why your family needs a primary
care physician and how you can find the right one. 01/26/05
NCQA's Health Plan Report Card - 01/26/05 has results on hundreds of managed care organizations that care for commercially insured individuals and Medicare and Medicaid beneficiaries. You can create a customized Report Card that shows results for the health plan or plans you want to know about.
Managed Care questions to consider when choosing an HMO.
Managed Care Regulations by State 01/26/05
Your Guide to Managed Care Contains section on picking a plan. 01/26/05
What Questions Do I Ask? 01/26/05
California Health Scope A resource for making choices about your health care!
Administrators in Medicine operate, an organization of state medical board directors, operates a Web site where you can find information on doctors in a growing number of states. This information includes disciplinary actions, but not malpractice histories (USA TODAY, May 19, 1997, P.3A).
Choosing and Using an Hmo (Bloomberg Personal Bookshelf), by Ellyn Spragins, Hardcover - 255 pages (November 1997), Bloomberg Pr.
Table of Contents
The Bloomberg Personal Bookshelf is a series of print products on personal finance that have been converted to 3-hour, two-cassette abridged audiobooks by DH Audio. Choosing and Using an HMO is an essential guide to a very difficult topic. The author has done a good job organizing her information, writing it and reading the final products. Spragins comes off as an expert. Furthermore, she successfully argues that the consumer needs this information. Anyone starting a family could benefit greatly HMO audiobook. It covers a lot of ground in a well-organized way. The audio is accompanied by a booklet of resources, worksheets and summaries. M.P. ©AudioFile, Portland, Maine.
The Complete Idiot's Guide to Managed Health Care (Complete Idiot's Guides), by Sophie M. Korczyk, Hazel A. Witte, Paperback - 300 pages (January 1998), Alpha Books
Table of Contents
Part 1: Getting Your Bearings
Health Insurance : How to Get It, Keep It, or Improve What You'Ve Got, by Robert Enteen, Paperback - 307 pages 2nd edition (July 1996), Demos Vermande.
Table of Contents
1. Health Insurance Basics
2. Health Insurance Needs
3. The Options Checklist
4. Group and Individual Plans
5. Blue Cross and Blue Shield Plans
6. HMOs and PPOs
7. Health Insurance "Pools" for "High-Risk" People
8. Long-Term Care Insurance
9. Short-Term Plans
10. Hospital Indemnity and Specified ("Dread") Disease Plans
11. Federal Employees Health Benefits Program
12. Veterans' Benefits
13. CHAMPUS (Civilian Health and Medical Program of the Uniformed Services)
14. CHAMPVA: Department of Veterans Affairs)
16. Medicare Supplement ("Medigap")
18. Free and Low-Cost Care for the Poor
19. Continuation and Conversion of Coverage When Leaving an Employer Group Plan (Regular and Special "COBRA Options")
20. Maximizing Claims
21. Sources of Help When You Have Insurance Problems
HCFA's Managed Care Manual Managed Care Resource Information Directory.
Medicare Health Plan Compare - (added 12/28/00) helps you obtain detailed information on Medicare's health plan options. By "comparison shopping," you can find the plans that are best for you. Different comparisons you can make for plans include:
Medicare.Gov - official U.S. Government Internet site for Medicare consumer information. It is designed to offer a variety of useful and easy to read information about Medicare.(added 12/17/00).
Medicare Managed Care - An on-line educational booklet.
Medicare Rights Center (MRC) - 01/26/05 national, not-for-profit organization that helps ensure that older adults and people with disabilities get good affordable health care..
Medication Assistance Programs - (added 12/17/00) provides detailed information about each company's assistance program, including the company's name, the program's address, the telephone and fax numbers, guidelines and notes, the health care provider's role, the patient's role, information needed to initiate enrollment, information regarding the amount of medication and how it is dispensed, refill information, the estimated response time, and limitations of the program.
For a $5 processing fee for each medication requested, the http://www.themedicineprogram.com site will assist the patient in the enrollment process. Patients without access to the Internet can contact a health care provider or a pharmaceutical company to receive information about medication assistance programs.
Other related sites include:
Guideline ClearinghouseTM - (added 12/28/00) public resource for evidence-based clinical practice guidelines. NGC is sponsored by the Agency for Healthcare Research and Quality (AHRQ) (formerly the Agency for Health Care Policy and Research [AHCPR]) in partnership with the American Medical Association and the American Association of Health Plans. Mission is to provide physicians, nurses, and other health professionals, health care providers, health plans, integrated delivery systems, purchasers and others an accessible mechanism for obtaining objective, detailed information on clinical practice guidelines and to further their dissemination, implementation and use.
Health Benefit Plans and the ADA - (added 6/00) by Cornell University.
How Will Managed Care Fit Into the Lives of People With Disabilities? An article from the Hattie Larlham Foundation.
Guidance on the application of the Americans with Disabilities Act of 1990 to disability-based distinctions in employer provided health insurance - (added 6/00)
This interim enforcement guidance sets forth the Commission's [EEOC] position on the application of the Americans with Disabilities Act to disability-based distinctions in employer provided health insurance.
Care and Persons with Disabilities: Information on Managed Care
the National Multiple Sclerosis Society. link not working as
Issues in Adapting Managed Care Techniques to Developmental Disabilities.
Psychiatric Inpatient Stay for A Person with Developmental Disabilities.
Can Managed Care Work for the Developmentally Disabled? 10/11/98 resaching why link is not working!
Where Should We Stand On Managed Care? Commonwealth Coalition for Community.
The National Clearinghouse on Managed Care and Long-Term Services and Supports for Adults with Developmental Disabilities and Their Families Charting the Changing Tides of Managed Care and Long-Term Services.
MANAGED CARE and the Lives of People with Developmental Disabilities and their Families
NATIONAL MENTAL HEALTH SERVICES KNOWLEDGE EXCHANGE NETWORK - The Knowledge Exchange Network (KEN) is a source of information and resources on mental health. Call 800-789-2647 or visit their Web site. (added 6/27/98)
A Guide to Managed Ccare for People with Spinal Cord Injury
Do You Know Your Medical Rights?
Medicare failure to meet the needs of people with disabilities - especially non-elderly beneficiaries. Includes discussion of Medicare standards for coverage of wheelchairs, scooters and other durable medical equipment. (Added 8/00)
Meeting The Needs of People With Chronic and Disabling Conditions in Medicaid Managed Care xxx fact sheet which discusses "carve-outs" and other methods used to address the health care needs of people with disabilities.
National Health Law Program - (added 6/00) a national public interest law firm that seeks to improve health care for America's working and unemployed poor, minorities, the elderly and people with disabilities.
Steps to Take If You Are Not Satisfied With Your Health Care Services
The Insider's Guide to Hmos : How to Navigate the Managed-Care System and Get the Health Care You Deserve, by Alan J. Steinberg, Paperback - 256 pages (September 1997), Plume Books.
Table of Contents
Health Against Wealth : Hmos and the Breakdown of Medical Trust, by George Anders, Paperback - 304 pages Reprint edition, Chapters Pub Ltd.
From Amazon.com's Review:
If you have ever sought pre-approval for a necessary medical
or have had problems arranging appointments with a specialist, or have
seen a personal-care physician transferred to a distant clinic, George
Anders's book on the growth of health maintenance organizations (HMOs)
will confirm your worst fears. A reporter for the Wall Street Journal,
Anders provides a series of horrifying case studies: a six-month-old
who loses his hands and feet after a 42-mile journey to an HMO-approved
emergency room; residents of a small town in Tennessee afflicted with
outbreak of a painful bowel infection who find that the drugs needed to
suppress the epidemic are not covered; HMOs that select hospitals with
low success rates for heart-bypass operations because of cost factors.
Anders presents a powerful indictment of the emerging managed-care
for our national health-care system in this disturbing book.
From Booklist , November 1, 1996
Anders' analysis of managed care has at its core the supposition that HMOs are the de facto national health care policy of the U.S. and will cover employer-, Medicare-, or Medicaid-funded health insurance for four out of five Americans by the year 2000. He notes that the "takeover" of health care by HMOs resulted from market forces seeking to contain costs in a bloated health delivery system, and this takeover came about without a single citizen referendum or congressional vote. This book is for any ordinary person seeking to understand the issues surrounding the explosion of HMO influence and to learn what HMOs do well and where they fail. Anders is forthright in his critique of HMOs. He identifies the worst problems in managed care and considers possible solutions. His premise is that people primarily seek health insurance in order to have some medical security in a crisis. The reality of that security is often in doubt as Anders, through numerous interviews, relates stories of experiences that individuals have had with HMOs in times of crisis. Anders suggests that employers may eventually bypass HMO middlemen by dealing directly with doctor and hospital groups that are well managed and committed to cost containment but are also committed to high-quality patient care.
Mary Whaley, Copyright© 1996, American Library Association. All rights reserved.
California Managed Health Care Improvement Governor's Task Force - Meeting the Needs of People with Disabilities Reccomendations drafted by Laura Remson Mitchell, Government Issues Coordinator, Multiple Sclerosis California Action Network.
The Center on Human Policy is a Syracuse University based policy, research, and advocacy organization involved in the national movement to insure the rights of people with disabilities. Site includes a helful group of disability-related links.
Center for Studying Health System Change (HSC) - (added 12/11/00) a non-partisan policy research organization which provides analyses about the effects of health system change to inform the thinking and decisions of policy makers in government and industry. HSC does not advocate policy positions, but is a resource for decision makers on all sides of the issues because of its reliable data and objective analyses.
Citizens for the Right to Know - (added 12/17/00) a network of approximately 80 consumer and specific disease organizations representing hundreds of thousands of people across the country. Members share a common need -- access to quality information on health care plans in order to make informed consumer choices. The objective is to pursue basic consumer fairness in health care by requiring insurers, health service organizations and HMOs to provide people with necessary information on coverage principles, benefits and any exclusions or restrictions. Includes information on:
Data Guide: Using Data: A Guide for Community Health Activists - (added 12/28/00) An introduction to getting and using data for the data-shy. Guide discusses the value of using quantitative and qualitative data to score points with health care providers, funders and the media. It suggests where to go to get data, and describes some simple ways to present it and an appendix of specific sources for various types of data.
Health Rights Hotline - (added 12/17/00) helps people take charge of their health care. Part of taking charge involves understanding your health care rights. Site provides some general information about your rights as a health care consumer. Although information is based on California law, it may still be useful even if you live in another area.
Disability Related Advocacy Links
Organization of Physicians Who Care provides legislative
and other information regarding happenings in health care.
Texas Cancer Data Center
provides online cancer information on health professionals, facilities
and services, cancer statistics,
population, and community resources. TCDC is funded by the Texas Cancer Council, the state agency whose goal is to improve the availability
and quality of cancer services and information in Texas.
Research and Training Center on Managed Care and Disability information about the NRH-RC/ILRU collaborative center.
Building Health Systems Grantees from the Center for Health Care Strategies (CHCS)
Medicaid Demonstration Project of New York State
Health, Wellness and Aging with Disability Reviews what is currently known regarding aging with disability; list new realities, new concerns regarding health, exercise, maintaining functional abilities, and many research questions; advocating for health reform and more; best practice information and guidelines; health services, assessment and evaluation guidelines; need for national information and dissemination network; role of independent living centers and other disability-related organizations; horror stories; and tips for weighing whether you'll use the gear; definitions; includes resource list (described below) and recommended readings.
Resource List: Wellness, Self-Care, Exercise & Aging with Disability Edition III
Editon II is available at http://www.usc.edu/go/awd.
Health, Wellness and Aging with Disability
Surgery on the Go Increasingly more procedures are done on an outpatient basis. Are you a candidate for outpatient surgery?
Health Care Choices for Today's Consumer : Guide to Quality and Cost, by Marc S. Miller (Editor), Families United for Senior Action Foundation, Philippe Villers, Paperback - 457 pages Revised edition (August 1997), John Wiley & Sons.
Table of Contents
California Department of Managed Care - (added 12/18/00)
HealthScope - Pacific Business Group on Health (PBGH) California Consumer is an independent source of information to help select the best quality health plans, hospitals, and medical groups. (added 12/17/00)
Office of Statewide Health Planning and Development (OSHPD) - (added 12/28/00) a department of the California Health and Human Services Agency. Its mission is to plan for and support the development of health care systems, which meet the current and future needs of the people of
American Medical Association Physician Select - Provides basic professional information on virtually every licensed physician in the United States and its possessions, including more than 690,000 doctors of medicine (MD) and doctors of osteopathy or osteopathic medicine (DO). AMA member physicians are offered an "expanded" listing that contains additional information such as office hours, practice philosophy, physician achievements, and other helpful information for visiting consumers. All physician credential data have been verified for accuracy and authenticated by accrediting agencies, medical schools, residency training programs, licensing boards, and other data sources. (Updated 3/1/01)
Physician specialty certification information - Owned and operated by the American Board of Medical Specialties. Does not contain all specialty boards but includes over two dozen. (Updated 3/1/01)
Providers, Comprehensive Information - about more than 500,000 doctors, and other health care providers in the United States. You can rate your doctors, search for details about a particular provider, and compare details about multiple providers in your area. (Updated 3/1/01)
Examples of what you can do:Provider Licensing and Disciplinary Information - Association of State Medical Board Executive Directors, you can find information on doctors in a growing number of states. This information includes licensing data and may or may not include information on hospital disciplinary reports, malpractice judgments, arbitration awards and malpractice histories. (Updated 3/01/01)
- Rate your doctors according to eight simple criteria
- Compare specialists in your state and locality on key criteria such as years in practice, training, plan affiliation, clinical interests and office services
for the Right Surgeon Not every surgeon in skilled at every type of
procedure. Before you schedule an operation, find out how to choose Dr.
Right. (Updated 3/1/01)
© 1998-2005 June Isaacson Kailes, Disability Policy Consultant, All Rights Reserved.
Created 4/7/98 | Updated 3/5/01 | as of 9/99 Accessed # 977
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