search for books and compare prices
Tables of Contents for Managed Care and Public Health
Chapter/Section Title
Page #
Page Count
Contributors
xiii
4
Foreword
xvii
4
Preface
xxi
2
Acknowledgments
xxiii
PART I CURRENT THEMES IN PUBLIC HEALTH AND MANAGED CARE
1
102
Chapter 1 Introduction
3
8
Paul K. Halverson
Glen P. Mays
Arnold D. Kaluzny
Opportunities for Managed Care and Public Health
4
1
Challenges for Public Health and Managed Care
5
4
Conclusion
9
2
Chapter 2 Current Practice and Evolving Roles in Public Health
11
31
Paul K. Halverson
Donald R. Haley
Glen P. Mays
Background
11
2
Organization of Public Health
13
19
Role of Public Health
32
1
New Developments in Public Health Practice
33
6
Conclusion
39
3
Chapter 3 Managed Care and Its Relationship to Public Health: Barriers and Opportunities
42
31
Curtis P. McLaughlin
Managed Care in the Public Sector
43
1
History of Health Care Financing
43
5
Stages of Managed Care Market Maturity
48
1
The Limited Role of Health Departments
48
1
Access, Cost, and Quality under Managed Care
49
3
A Sample Contract: The Case of North Carolina
52
2
The Vocabulary of Managed Care
54
1
Mapping the Relationship of Managed Care and Public Health
54
4
Legislative Responses
58
3
Prevention and Managed Care
61
2
Barriers to Prevention
63
1
Individual Provider Disinterest
63
1
Time Value of Prevention
63
5
Disenrollment
68
1
Lack of Integration
68
1
Conclusion
69
4
Chapter 4 Privatization of Public Hospitals: Trends and Strategies
73
10
Montague Brown
Background
73
1
Privatization Takes Many Forms
74
1
Reasons for Transformation
75
1
Broad and Accelerating Trends
76
1
Key Concerns for Privatization: Source of Decision Criteria
77
4
Conclusion
81
2
Chapter 5 Privatization and Health Care
83
20
Curtis P. McLaughlin
Privatization Alternatives
84
2
Alternative Control Mechanisms
86
3
Maintaining Accountability
89
1
Why Privatize?
90
1
Why Choose To Go For-Profit?
91
3
Alliances
94
3
TennCare
97
3
Conclusion
100
3
PART II APPLICATIONS OF MANAGED CARE AND PRIVATIZATION
103
80
Chapter 6 Managed Care for Medicaid Beneficiaries: An Overview
105
20
Robert E. Hurley
Debra A. Draper
Background
106
7
Current Issues and Developments
113
4
The Broader Context of Medicaid Managed Care
117
3
Key Questions and Concerns
120
3
Conclusion
123
2
Chapter 7 Privatizing Maternal and Child Health Services in Texas
125
12
Patti J. Patterson
J. Scott Simpson
Robbie J. Davis
Debra C. Stabeno
Linda L. Bultman
Background
126
2
Reinventing Title V Programs
128
3
The Prospects of Title V Redesign: Challenges and Opportunities
131
4
Conclusion
135
2
Chapter 8 Public and Private Sector Involvement in Managed Mental Health Care
137
20
Bruce J. Fried
Matthew C. Johnsen
Artemis H. Malekpour
A Historical View of Public and Private Participation in Mental Health Services
138
10
Managed Mental Health Care in the Public Sector
148
4
Unanswered Questions about Privatization of Mental Health Services
152
5
Chapter 9 Managed Care and the Delivery of Public Mental Health and Substance Abuse Services
157
14
Mady Chalk
Managed Care for Mental Health and Substance Abuse Treatment
157
2
Key Issues, Opportunities, and Challenges for Quality Management
159
3
Policy Implications for Quality Management
162
7
Conclusion
169
2
Chapter 10 The Privatization of Quality Assurance in Health Care
171
12
Gary J. Young
Public Oversight of Quality
172
1
The Role of the Private Sector in Public Quality Assurance Programs
173
1
Expansion of the Private Sector Role in External Quality Assurance
174
2
Privatization of External Quality Assurance: Theoretical Issues
176
3
The Future Role of the Public Sector in External Quality Assurance
179
1
Conclusion
180
3
PART III CASE STUDIES IN PUBLIC HEALTH AND MANAGED CARE
183
138
Chapter 11 Managed Care, Public Health, and Privatization: A Typology of Interorganizational Arrangements
185
16
Glen P. Mays
Paul K. Halverson
Arnold D. Kaluzny
Models of Interaction Between Managed Care and Public Health
185
14
Conclusion
199
2
Chapter 12 Case Study: Integrated Public and Private Health Care Systems in Denver, CO
201
21
Glen P. Mays
Overview of the Community
201
4
Managed Care in the Public Health System
205
5
Public Health in the Private Health Care Market
210
9
Conclusion
219
1
Discussion Questions
220
2
Chapter 13 Case Study: Group Health Cooperative and the Public Health System Serving Olympia, WA
222
11
Curtis P. McLaughlin
Paul K. Halverson
Glen P. Mays
Overview of the Community
223
1
History of Group Health Cooperative
223
1
Utilization Management and Quality Improvement
224
2
Population-Based Health Care
226
1
Medicaid Managed Care
227
1
Health Services Research
228
1
Interaction with the Local Health Department
229
2
Conclusion
231
1
Discussion Questions
231
2
Chapter 14 Case Study: A Public Sector HMO in Portland, OR
233
10
Glen P. Mays
Overview of the Community
233
2
Overview of the Public Health System
235
1
History of Managed Care in the Public Health System
235
2
Current Challenges and Opportunities
237
3
Conclusion
240
1
Discussion Questions
241
2
Chapter 15 Case Study: Reconfiguring Memphis' Public Health System for Managed Care
243
9
Glen P. Mays
Overview of the Community
243
2
Managed Care and the Public Health System
245
3
Current Challenges and Opportunities
248
1
Conclusion
249
1
Discussion Questions
250
2
Chapter 16 Case Study: The Local Health Department's Role in Milwaukee's Managed Care Market
252
9
Glen P. Mays
Overview of the Community
252
2
The Public Health System's Role in Managed Care
254
2
The Private Sector's Role in Public Health
256
3
Conclusion
259
1
Discussion Questions
260
1
Chapter 17 Case Study: Privatizing a Community Hospital in Rocky Mount, NC
261
16
Curtis P. McLaughlin
Rocky Mount and Nash County
262
1
The New Lease Proposal
263
5
The Alternative Lease
268
1
The Counter-Offer
269
3
Recent Development
272
3
Conclusion
275
1
Discussion Questions
275
2
Chapter 18 Case Study: Providing Public Health Services through an Integrated Delivery System in Mecklenburg Country, NC
277
11
Stephen R. Keener
John W. Baker
Glen P. Mays
Rationale and History
278
1
Structure and Operation
279
2
Existing Approaches to Quality Management
281
3
Remaining Challenges for Quality Management
284
2
Conclusion
286
1
Discussion Questions
286
2
Chapter 19 Case Study: Hospital Privatization as a Quality Improvement Strategy in Jersey City, NJ
288
13
Jonathan M. Metsch
Donald R. Haley
Donald Malafronte
Privatization: Purpose and Process
289
5
Lessons Learned from Privatization of Health Care Delivery Systems
294
4
Conclusion
298
1
Discussion Questions
299
2
Chapter 20 Case Study: Privatizing the Mental Health System in King County, WA
301
20
Anne Y. Ilinitch
Curtis P. McLaughlin
The Title XIX Waiver
302
1
Authorization To Pursue Becoming a Prepaid Health Plan
302
1
Mental Health Activities in King County
303
1
Mental Health Categorization
303
4
The Current KCRSN Fee-for-Service Process
307
1
Decision To Have a Prepaid Health Plan in King Country
308
3
Implementation Problems
311
1
Privatization Options
312
1
Provider Agencies
312
1
Peregrine-Northwest
313
3
The Role of the State DSHS
316
1
Peregrine's Dilemma
317
1
Peregrine's Choices
318
1
Conclusion
318
1
Discussion Questions
319
2
PART IV MANAGING THE PUBLIC'S HEALTH: POLICY IMPLICATIONS AND CONCLUSIONS
321
44
Chapter 21 Ensuring Quality and Access under Managed Care
323
16
Pam Silberman
The Challenges of Managed Care
323
2
Mechanisms To Ensure Access and Quality
325
3
How Well Do Oversight Mechanisms Protect Consumer Interests in Quality, Access, and Health Status Improvement?
328
4
Where Do We Go from Here?
332
7
Chapter 22 Public Health, Privatization, and Market Populism: A Cautionary Note
339
11
Dan Beauchamp
The Market and Democracy
340
1
Market Populism
341
2
Public Health as a Prophetic Voice
343
2
Public Health as a Voice for the Community
345
5
Chapter 23 Strategies for Managing the Public's Health: Implications and Next Steps
350
15
Paul K. Halverson
Arnold D. Kaluzny
Curtis P. McLaughlin
The New Frontier
351
1
Implications of Privatization
352
5
Next Steps
357
4
Conclusion
361
4
Appendix A Medicaid Managed Care Risk Contract Between the State of North Carolina, Division of Medical Assistance, and a Health Maintenance Organization
365
68
Appendix B Sample Contract Between a Local Health Department and a Health Maintenance Organization
433
20
Index
453