Health Insurance and Managed Care: What They Are and How They Work is a concise introduction to the workings of health insurance and managed care within the American health care system. Written in clear and accessible language, this text offers an historical overview of managed care before walking the reader through the organizational structures, concepts, and practices of the health insurance and managed care industry.
The Fifth Edition is a thorough update that addresses the current status of The Patient Protection and Affordable Care Act (ACA), including political pressures that have been partially successful in implementing changes. This new edition also explores the changes in provider payment models and medical management methodologies that can affect managed care plans and health insurer.
"The quality of this book is outstanding. I was impressed by the amount of detail that greatly aided understanding. The online content is also very useful and a great addition. This update is warranted by the information about ACA that was not available for the previous edition."
-- Jessica Ferraro, MHA (James A. Haley Veterans' Hospital) Doody's Review - previous edition
The audience includes anyone who wishes to understand how health insurance and managed care work.