As the most widely-used textbook on managed care, Essentials of Managed Health Care provides an authoritative and comprehensive overview of the key strategic, tactical, and operational aspects of managed health care and health insurance. With a primary focus on the commercial sector, the book also addresses managed health care in Medicare, Medicaid, and military medical care. Important The digital edition of this book is missing some of the images or content found in the physical edition.
Comprehensive to the point of redundancy and exhaustion. It really has full breadth of material, though it could have gone more in depth on underwriting and actuarial science as it goes so painfully in depth into so many other, less important, aspects of health care. But that's my slant as I was reading it from the perspective of a new payer organization employee, so understanding those more in depth would have been helpful. I'm giving it 4 stars because I wanted something with a lot of content, and this delivered, but the delivery of said material has quite a lot of room from improvement
The content of the book is fair to good, but the writing is VERY uneven.
(Stands to reason as the chapters were written by a variety of authors - it's too bad some of them are clearly not actually writers.)
Also, wouldn't you think an editor would be a good idea?
Check out some lovely examples of how not to open your chapter:
"To manage successfully a managed care organization or payer organization, the value financial managers provide their organizations starts with their ability to interact with the operational and medical managers, to manage changes in the regulatory environment, and gather timely information to facilitate communication of financial results to the organization and its constituencies to react appropriately to sustain or exceed financial goals...
The focus of this chapter is a review of the components of the financial statements of a payer, key information and the operational procedures that the financial manager will need and rely upon, addresses typical problems that occur in gathering information and provides insight into the challenge of the integrity of information."
Excellent comprehensive overview of the complex acronym-cluttered landscape of managed care. Like the "Handbook of Managed Care" by the same author, but with a few chapters omitted.