ManagingManagedCare.com
Learn and discuss how to improve Manged Care

Maintained by Dr. Jeffery G. Kaplan, MD,
this site is dedicated to making Managed Care evidence based care.

home > Future of Managed Care

The Future of Health Care

Top Issues Facing Health Care
over the next 5 years

(includes Defined Contribution/Benefit Plans)


Connectivity. EDI is now in > 1/3 Medical Practices; "Technology Usage in Physician Practice Management."

A Lexicon for Information Flow E.G., Dashboard? The more relevant Codes (CPT, ICD care, etc. Site of Service, and other related codes)? What does HIPAA say about electronic coding standards? Also, see Medscape who excels on clarity on coding issues.


Disease Management Without Disease Managers by Al Lewis as published 10/01/2001 in Managed Care Interface "In the last 24 months, the classic skeptic's question about disease management has shifted from: "Does it work?" to "Sure, it works, but is it cost effective?" The skeptics observe that the telephone banks operated by nurses cut deeply into the gross savings and utilization reduction generated by patient education and monitoring. True believers have countered with, "Just wait until you see the results of the Web-based systems. They can monitor and educate without phone banks."

Click on Health Hero to see the HealthBuddy--:The Industry Leading Technology Platform for Remote Communications, Monitoring and Care Management. To order, please contact Marie Mann and tell her Dr. Jeff Kaplan sent you for special attention.


Filing Appeals Doctors: Want to eliminate a headache? (Note: If this link does not work, please see the Integrated Healthcare News, page 2). MCOs: Need to be incompliance with regulation about denials, appeals and clinical record evaluations (DARE)



Informatics, Medical     Handling health information in Practice
Healthcare Information and Management Systems Society (HIMSS)
Healthcare Information Technology Yellow Pages
Healthwave, Inc. - Integrative information technology technology
Internet Healthcare Coalition
NIH's Center for Information Technology

Compare and select a hospital using It enables health paln members or employees to using evidence-based comparisons. They report the "top" hospitals for over 50 specific diagnoses and procedures (parameters include patient volume, mortality rates and unfavorable outcomes). SQC is seamlessly integrated with member portals or employee intranet and can be viewed online, printed, or saved.

Reports

Reports What if you had a reliable report that encouraged those reviewed to improve their performance? What if the same method helped pay practitioners fairly, realigned the incentives, improved the quality of data and served as the basis of case, demand, and disease managment?


SmartCare, the most important managed care information tool of our time also happens to be the fairest. And, it can be installed nearly painlessly, complementing virtually any health care or claims information system; Amazing results can be yours with

  3M HIS's CRGs
The birth of Clinical Risk Groups (Move your cursor to the pregnant lady. Gently Click on the babe . . . . Be patient; it's loading a 31 slide PowerPoint show

To see best of breed reporting (MS Word Version).
Visualize how they fit, e.g., with Asthma and Diabetes
To get the free Adobe Acrobat 5.0 Reader, click here)

An open letter describing my experience with CRGs. You may qualify for a free install and 6-month trial.
For further information, please go to "Current I.T."

 

Please contact Dr. Jeffrey G. Kaplan for further information.


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