The Reality of Managed Health Care: Implications for AAC Service Delivery

1998 ◽  
Vol 7 (2) ◽  
pp. 4-5
Author(s):  
Jane W. Murphy
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Managed Health Care

ERISA Preemption and Regulation of Managed Health Care: The Case for Managed Federalism

1997 ◽  
Vol 23 (2-3) ◽  
pp. 251-289
Author(s):  
Margaret G. Farrell
Keyword(s):  
Health Care ◽  
Retirement Income ◽  
Structural Reforms ◽  
Unborn Child ◽  
Income Security ◽  
Care Plans ◽  
Managed Health Care ◽  
Federal Statute ◽  
Managed Care Organizations ◽  
Retirement Income Security

The result ERISA compels us to reach means that the Corcorans [who lost their unborn child allegedly as a result of United Healthcare’s negligent determination that hospitalization was not medically necessary] have no remedy, state or federal, for what may have been a serious mistake. This is troubling....In the words of its sponsor, Senator Jacob Javits, the Employee Retirement Income Security Act (ERISA) was enacted in 1974 “to maintain the voluntary growth of private [pension and employee benefit] plans while at the same time making needed structural reforms in such areas as vesting, funding, termination, etc. so as to safeguard workers against loss of their earned or anticipated benefits....” Ironically, one of ERISA’s provisions—its indeterminate provision for the preemption of state law—has probably created more uncertainty about the adequacy and security of health care benefits than any other piece of legislation. Neither ERISA nor any other federal statute comprehensively regulates the content of employer provided health care plans, including benefits provided through managed care organizations (MCOs).

Patient satisfaction with the quality of care in Ghana’s health-care institutions

2019 ◽  
Vol 13 (2) ◽  
pp. 160-170 ◽  
Author(s):  
Aaron Asibi Abuosi ◽  
Mahama Braimah
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Service Delivery ◽  
National Survey ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Content Type ◽  
Care Facilities

Purpose The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach. Design/methodology/approach The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis. Findings About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients were more likely to be satisfied with the quality of care, compared with males and uninsured patients. Research limitations/implications Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this. Practical implications The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem. Originality/value There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.

Drug Formulary: The Cornerstone of a Managed Pharmacy Program

1992 ◽  
Vol 5 (2) ◽  
pp. 75-81 ◽  
Author(s):  
Richard J. Bruzek ◽  
Debra Dullinger
Keyword(s):  
Health Care ◽  
Selection Process ◽  
Drug Evaluation ◽  
Evaluation Process ◽  
Outpatient Setting ◽  
Hospital Environment ◽  
Drug Formulary ◽  
Managed Health Care ◽  
Cost Efficiencies ◽  
Evaluation Matrix

Drug formularies have migrated from the inpatient hospital environment to the ambulatory outpatient setting. Although formularies in use by managed health care organizations may vary widely in their design, they have quickly become the cornerstone of the managed pharmacy benefit. A carefully designed formulary can direct drug use to the safest and most efficacious products that may ultimately lower total drug costs. Other managed health care drug formulary considerations are presented. A method is described to develop a drug formulary. The drug evaluation matrix (DEM) provides a systematic, reproducible drug selection process based on efficacy, safety, and cost. DEM allows the user to assign different weights to these factors during the drug evaluation process. The product of DEM is a drug formulary that is therapeutically complete, consistent with accepted medical practice and maximizes cost efficiencies achievable from a drug formulary.

scholarly journals The race to the top initiative: towards excellence in health-care service delivery

2015 ◽  
Vol 3 ◽  
pp. S16
Author(s):  
E Nahimana ◽  
H Iyer ◽  
A Manzi ◽  
A Uwingabiye ◽  
N Gupta ◽  
...  
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Care Service ◽  
Health Care Service ◽  
Race To The Top ◽  
Health Care Service Delivery

The Managed Health Care Market

1992 ◽  
Vol 5 (2) ◽  
pp. 67-71
Author(s):  
William A. Hemberger
Keyword(s):  
United States ◽  
Health Care ◽  
Managed Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
The United States ◽  
Health Care Market ◽  
Managed Health Care ◽  
Program Benefit

Health care delivery and benefits in the United States are changing. This article provides a basic description of the present-day components, managed care constructs, and impact of medical/hospital program/ benefit designs on pharmacy programs.

Increasing Pediatric Audiology Services via Telehealth

2021 ◽  
Vol 42 (02) ◽  
pp. 136-151
Author(s):  
Tommy Evans ◽  
Timothy Nejman ◽  
Erin Stewart ◽  
Ian Windmill
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Case Studies ◽  
Health Care Services ◽  
Medical Center ◽  
Access To Healthcare ◽  
Hospital Medical ◽  
Care Services ◽  
Telehealth Service ◽  
Pediatric Audiology

AbstractTelehealth as a means to deliver health care services has been used by physicians for many years, but the use of telehealth in audiology, specifically in pediatrics, has been minimal. Barriers such as licensure, reimbursement, technology, and equipment have been cited as reasons for audiologists not participating in telehealth. However, the COVID-19 pandemic created the need for telehealth services to be widely used to safely increase access to healthcare, and emergent orders helped reduce previous barriers so that audiologists could participate in telehealth service delivery. This article details three cases where audiologists delivered telehealth services to children. These case studies demonstrate portions of the Division of Audiology Telehealth Program of the Cincinnati Children's Hospital Medical Center and how they increased access to hearing healthcare in response to the COVID-19 pandemic.

The role of transformative healthcare technology on quality of life during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammad Asif Salam ◽  
Saleh Bajaba
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Saudi Arabia ◽  
Service Delivery ◽  
Health Care System ◽  
Service System ◽  
Content Type ◽  
Care System

Purpose The purpose of this study is to investigate the role of the COVID-19 health-care system quality (HSQ) and its impact on the individual (satisfaction) and social (quality of life [QOL]) outcomes in the context of a transformative health-care delivery system using service-dominant logic (SDL). Design/methodology/approach A sample consisting of 1,008 individuals who have experienced the COVID-19 health-care system was drawn from four different regions of Saudi Arabia using the simple random sampling technique. The survey was conducted using an online survey and 1,008 respondents answered, based on their experience and knowledge of the COVID-19 health-care system. Partial least squares structural equation modeling was applied to test the proposed research model. Findings The study findings suggest that service system satisfaction (SAT) significantly mediates the role of the HSQ in delivering and enhancing the QOL. HSQ also has a significant role to play on the SAT as well as the QOL. These findings contribute to the body of knowledge on SDL in the context of HSQ in understanding the significant role of technologies can play in enhancing service satisfaction and better QOL during a crisis such as COVID-19. This study also improves the understanding of the importance of customer-centricity, real-time visibility through tracking and tracing of service flow, agile decision-making, fewer but better-defined service objectives, and finally shaping mindsets and behaviors of all the relevant parties involved in the HSQ service delivery process. Research limitations/implications One of the major limitations of this study is that, although COVID-19 is an ongoing global pandemic, cross-sectional data were collected in only one country. The findings may not be generalizable across subsequent waves of the pandemic. The best practices of HSQ could be studied around the globe and the results used to support continuous improvement. Originality/value This study advances the understanding of the SDL in the context of a transformative health-care system for a transitional economy by focusing on individual and social well-being during an unexpected crisis such as the COVID-19 pandemic. This study also contributes toward the understanding of the roles of enabling technologies to improve the service delivery system which results in an improved SAT, as well as better QOL for the society at large. Based on SDL this research validates the HSQ model, relevant measures and its overall impact on SAT and QOL in the context of a transformative health-care service system in Saudi Arabia.

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