Evaluating managed care networks with claim data
Article Abstract:
Comparison of managed care claims with projected claims based on analytical models help plan sponsors determine if managed care providers are delivering low-cost services. Professional cost savings under fee-for-service schemes are accurately evaluated by means of the utilization component rather than by direct fee comparison. Under capitation schemes, capitation rate is determined by comparing the market value of capitated services based on the claim data, with the capitation fees.
Publication Name: Journal of Compensation and Benefits
Subject: Insurance
ISSN: 0893-780X
Year: 1996
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Mandated parity: curing the mental health insurance gap?
Article Abstract:
Managed care plans can be used to achieve parity between mental health coverage and physical health coverage. They help reduce the costs of mental health treatment through concurrent reviews or pre-authorization of health services. They also restrict the number and duration of hospital treatment to treat psychiatric illness. Increased mental health coverage through managed care plans would raise worker productivity and create happier lives.
Publication Name: Journal of Compensation and Benefits
Subject: Insurance
ISSN: 0893-780X
Year: 1996
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Patient satisfaction surveys: what employers need to know
Article Abstract:
Properly conducted surveys accurately determine patient satisfaction with health care providers and plans. Questionnaires should be clearly worded to elicit accurate responses. They should start with less probing questions rather than controversial and demographic ones. The survey process as a crucial aspect of surveys includes the method of survey administration, sampling, confidentiality and analysis of results.
Publication Name: Journal of Compensation and Benefits
Subject: Insurance
ISSN: 0893-780X
Year: 1996
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