Managed care trends: the effect on subacute care

Article Abstract:

There are five models of enrollment in health maintenance organizations (HMOs), all of which variously impact subacute care providers. The HMO in a group model contracts with a physician group. Physicians in a staff model work for the HMO, which is a decreasing trend. In a network model, the HMO develops widespread connections between physician groups. This is similar to an individual practice association, where the HMO contracts individual physicians. The newest form is an open-access HMO, where the primary care physician does not need approval for referral to a specialist.

Social aspects, Models, Management, Managed care plans (Medical care), Medical corporations, Hospital-physician joint ventures

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Disease management: a challenge to subacute care

Article Abstract:

Disease management (DM) is beginning to reduce health care costs. DM is a coordinated effort between managed care organizations, pharmacy groups, and employer groups to establish treatment protocols for patients with conditions requiring the highest care costs. DM programs focus on establishing care guidelines for emergency department visits and acute care for outpatients and inpatients, but DM practices will eventually influence subacute protocols.

Analysis, Economic aspects, Chronic diseases, Medical care, Cost of, Health care costs

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