Community Providers and Managed Care
The majority of the issues or sites relate to Home Care but there is some relation to long term care as well. The sites range from formal (The Arc) and nformal (Physicians Who Care) organizations to advertisers (Pt Care Technologies) to Federal regulatory agencies (HCFA) to local network presentations (Netstation).
The information provided is as broad as the sites. Issues such as the
appropriateness of providing mental health services under a managed care arrangement are debated or whether managed care's methods of decreasing
utilization will be effective in the Medicare population. The question arises that if HMO's continue to be forced to lower utilization will it be at the expense of the health of the elderly and/or the elimination of needed services. In looking at community providers and the populations
they serve the question is also raised about whether prepaid care in rrelatively healthy populations can be replicated among sicker patients. Netstation provided a lot of good information for consumers to consider before going into an HMO situation and the HCFA site gave specific information on HMO marketing rules and complaint/grievance procedures
when these are not followed. These sites and documents don't answer all the questions but they begin to build a base of information necessary for consumers and providers alike on managed care and the community.
Documents
- HCFA's Managed Care Resource Directory
- Found under HCFA site, Part II of the 1995 Managed Care Resource Information Directory. Includes information about marketing of managed care plans to MCR enrollees, questions of reimbursement, duplicate coverage and complaint/greivance procedures.
- Maxim #5: Managed Care May Threaten The Health Of Elderly Enrollees
- Document found under Physicians Who Care Site.Article discusses whether managed care can achieve further reduction in utilization or whether further reduction would result in elimination of needed services resulting in reduction of the health of Elderly.
- October 1995 Table of Contents
- Magazine reference found through Home Care on Line Site. Good article selection on Managed Care buyt articles were not available for view at this time only the Table of Contents.
- The Elderly Have Unique Health Care Needs That May Be Unsuited For Managed Care
- A second article found under the site of Physicians Who Care. Concerned as to whether the experience in the private HMO market can be replicated amoung senior citizens.
- Your Money & Your Life
- Found at Netstation site.Show that aired on PBS on Sept6. Focuses on consumer issues raised a bout managed care. Included overview,real life stories, viewpoints and discussion and other information.
Sites
- Health Care Financing Administration (Medicare & Medicaid)
- HCFA stands for the Health Care Financing Admin. Under this site I located a document on managed care marketing activities for medicare and medicaid. Other topics available at this site include MCR/MCD overview, Quality of Care Issues and MDC Handbook
- National Organization of Physicians Who Care
- Patient Care Technologies - The Home Care Page (SM)
- PtCt is an advertiser site. I was unable to use it as a resource for documents but it did provide information about other home care sites including Home Care Industry Internet Resources, Product of interest to home care, and info of interest to patients.
- The Arc, a national organization on mental Retardation
- Site for article managed care and long term services. The Arc is a national organization committed to the welfare of children and adults with mental retardation. As an organization adopts positions on issues that affect people with retardation.
- Welcome to HOMECARE OnLine!
- Through Home Care on Line I found articles specific to home care and managed care but they are not yet available for view. This site lists Information available through the National Association for Home Care including Caring Magazine.
- wNetStation
- Site for WNET Channel 13. Presents 11 venues available for view. Your money and your Life was one of those presented under which was found information on managed care.
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