Introduction of managed care plans in a cardiac surgery unit

1994 ◽  
Vol 3 (4) ◽  
pp. 189-194 ◽  
Author(s):  
Suzanna Kingsland ◽  
Penny Smith ◽  
Sharon McKinley
Keyword(s):  
Cardiac Surgery ◽  
Managed Care ◽  
Care Plans

Aligning Medicaid and Medicare Advantage Managed Care Plans for Dual-Eligible Beneficiaries

2021 ◽  
pp. 107755872110189
Author(s):  
Laura M. Keohane ◽  
Zilu Zhou ◽  
David G. Stevenson
Keyword(s):  
Nursing Home ◽  
Managed Care ◽  
Prescription Drugs ◽  
Service Use ◽  
Medicare Advantage ◽  
Percentage Point Increase ◽  
Care Plans ◽  
Point Increase ◽  
Dual Eligible ◽  
Home Users

To coordinate Medicare and Medicaid benefits, multiple states are creating opportunities for dual-eligible beneficiaries to join Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs) and Medicaid plans operated by the same insurer. Tennessee implemented this approach by requiring insurers who offered Medicaid plans to also offer a D-SNP by 2015. Tennessee’s aligned D-SNP participation increased from 7% to 24% of dual-eligible beneficiaries aged 65 years and above between 2011 and 2017. Within a county, a 10-percentage-point increase in aligned D-SNP participation was associated with 0.3 fewer inpatient admissions ( p = .048), 13.9 fewer prescription drugs per month ( p = .048), and 0.3 fewer nursing home users ( p = .06) per 100 dual-eligible beneficiaries aged 65 years and older. Increased aligned plan participation was associated with 0.2 more inpatient admissions ( p = .004) per 100 dual-eligible beneficiaries younger than 65 years. For some dual-eligible beneficiaries, increasing Medicare and Medicaid managed plan alignment has the potential to promote more efficient service use.

Managed Care

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 278-279
Author(s):  
JENIFER D. C. CARTLAND ◽  
BETH K. YUDKOWSKY
Keyword(s):  
Managed Care ◽  
Medical Care ◽  
Care Program ◽  
Kaiser Permanente ◽  
Care Plans

In Reply.— Doctors Sapin and Laws raise fundamental concerns about our article that was recently published in Pediatrics.1 We feel that these concerns are addressed adequately in the paper, but we would like to take this opportunity to clarify our findings. Dr Sapin argues that our study characterizes all managed care plans, such as the Kaiser Permanente Medical Care Program in which he practices, as having ineffective referral mechanisms. He holds that pediatricians at Kaiser experience "no barriers to appropriate referrals" and indicates that we did not stress this finding adequately.

scholarly journals A National Survey of the Arrangements Managed-Care Plans Make with Physicians

1995 ◽  
Vol 333 (25) ◽  
pp. 1678-1683 ◽  
Author(s):  
Marsha R. Gold ◽  
Robert Hurley ◽  
Timothy Lake ◽  
Todd Ensor ◽  
Robert Berenson
Keyword(s):  
Managed Care ◽  
National Survey ◽  
Care Plans

Are Managed Care Plans Organizing for Quality?

2000 ◽  
Vol 57 (3 suppl) ◽  
pp. 9-32 ◽  
Author(s):  
D. P. Scanlon ◽  
E. Rolph ◽  
C. Darby ◽  
H. E. Doty
Keyword(s):  
Managed Care ◽  
Care Plans

scholarly journals Implementation of a Comprehensive Tobacco-Cessation Policy in Medicaid Managed Care Plans in California

2020 ◽  
Vol 59 (4) ◽  
pp. 593-596
Author(s):  
Sara B. McMenamin ◽  
Sara W. Yoeun ◽  
Joanne P. Wellman ◽  
Shu-Hong Zhu
Keyword(s):  
Managed Care ◽  
Tobacco Cessation ◽  
Medicaid Managed Care ◽  
Care Plans

scholarly journals Selection of a cardiac surgery provider in the managed care era

2000 ◽  
Vol 120 (5) ◽  
pp. 978-989 ◽  
Author(s):  
David M. Shahian ◽  
Winnie Yip ◽  
George Westcott ◽  
Jerilynn Jacobson
Keyword(s):  
Cardiac Surgery ◽  
Managed Care ◽  
Selection Of
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