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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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PubMed1988

Managing a successful organizational change.

To survive in today's competitive environment, hospitals must prepare themselves to effectively manage organizational changes such as downsizing or mergers. By analyzing the change process and understanding key roles, managers will be likely to ensure a smooth and successful transition. And a smooth and well-managed change will produce positive results by reducing the amount of time needed for the change to take affect, minimizing or avoiding productivity declines, keeping morale high, and encouraging confidence in hospital leadership.

Efficiency↗
PubMed1997

The quality evolution in managed care organizations: shifting the focus to community health.

Community demand for high-quality, cost-effective health care is forcing many new changes for managed care organizations (MCOs). Competition among MCOs often prevents cooperative and comprehensive approaches to the enhancement of the health status of the community. MCOs are beginning to measure quality based on the health of enrolled populations, and communities are seeking communitywide quality of care indicators. To cope with the demands of capitated health care, MCOs need to shift their focus to managing the health status of specific community populations. Strategies for managing the health status of populations include community assessments, collaboration among competing players, and a focus on consumer health information.

Community Health Planning↗
PubMed1998

Practices retain control with a nonacquisition model PPMC.

Traditional PPMCs acquire the assets of a physician practice and provide management services. Physicians pay a management fee for these services and relinquish control over their practice. With a new nonacquisition model PPMC, physicians retain ownership of and control over their practices. In return for a management fee, they receive management expertise and capital. The result should be practice revenue growth. This growth is achieved by developing a strategic plan, getting physician buy-in before implementing the plan, and monitoring the results.

Credentialing↗
PubMed1996

Managing risk in a changing health care system.

This article examines the information requirements and other strategies needed to manage business and financial risk in health care organizations. The business and financial risk of providers in the changing health care market is defined. The major factors that are increasing risk are outlined, and strategies for measuring and managing risk are discussed. The interaction of business and financial risk is described, and strategic goals that will minimize the effect of this interaction are presented.

Capitation Fee↗
PubMed1996

The rigors and rewards of clinical evaluation in an alliance of academic health systems.

The University HealthSystem Consortium (UHC), a 70-member alliance of academic health centers, was established in 1984 to help its members improve clinical practice and to strengthen their competitive position in the health care market. This article describes the programs of the UHC's Clinical Practice Advancement Center and its progress to date in promoting strategies to control cost, demonstrate value, and improve health care quality.

Academic Medical Centers↗
PubMed1991

The impact of managed care on physicians.

This article examines the forces that led to managed care and considers its two main thrusts: traditional indemnity, with controls and constraints through utilization review, and controlled access and reimbursement, as seen in the HMO model. The strategies available to the physician are discussed, suggesting how managed care can itself be managed. Finally, the evolution of managed care is shown to be in a final phase, wherein efficient and effective physicians are identified by computer data for selective contracting, leaving a sizeable minority of (potentially) unemployed physicians.

Contract Services↗
PubMedDate not supplied

Getting to the bottom line. Hospitals' survival may hinge on the contribution margin.

Healthcare managers have devoted increasing attention to product line management in the face of growing competition. The general belief has been that although product line management and the contribution approach (internal financial reporting and analysis that distinguish between variable and fixed expenses and include the contribution margin) help enhance profitability for hospitals that have the prerequisite software systems and management expertise, they are hardly necessary for survival. But the contribution approach to product line management may indeed be required for survival for all hospitals. Current hospital accounting systems do not provide information on which products contribute to fixed expenses and profitability and which, although vital, are financial losers. Product line managers need this information to make optimal decision trade-offs among quality, availability, and benefits of medical services. The contribution margin is the difference between the fee received for the service and the variable expenses incurred in providing the service. It represents the resources available to cover fixed expenses that will occur regardless of volume and to provide a profit (or, for the not-for-profit, to provide working capital and expand services).

Accounting↗
PubMed2000

Planning documents: a business planning strategy.

Strategic planning and business plan development are essential nursing management skills in today's competitive, fast paced, continually changing health care environment. Even in times of great uncertainty, nurse managers need to plan and forecast for the future. A well-written business plan allows nurse managers to communicate their expertise and proactively contribute to the programmatic decisions and changes occurring within their patient population or service area. This article presents the use of planning documents as a practical, strategic business planning strategy. Although the model addresses orthopedic services specifically, nurse managers can gain an understanding and working knowledge of planning concepts that can be applied to all patient populations.

Commerce↗
PubMedDate not supplied

Health care futures. What lies ahead? Where are we going? Panel discussion.

Who would have guessed that managed care would dominate the health care industry in the final two decades of the millennium? That physicians would be joining labor unions? Or that they would be going back to school to become Fellows of the American College of Physician Executives? To find out what may be in store for health care in America five to 10 years hence, The Physician Executive asked nine health care experts to participate in a two-part panel discussion. Here's what they see ahead in managed care, information technology, and biotechnology. Part 2 will appear in the July/August Issue of The Physician Executive.

Biotechnology↗
PubMed1996

[The Swiss health insurance carriers in managed care].

The Swiss health care system is currently undergoing radical changes. The balance of power is clearly shifting from the service-providers to the health insurers. Excessive patient demands combined with proliferation of medically unnecessary treatment have led to an inflation of cost equivalent to several billion Swiss francs. Managed Care is a new instrument that enables the insurers to influence patient behavior and, hence, the services offered in an integrated fashion. The key factors necessary for the success of this process are: Clear and timely information with the insured Product design based on precise segmentation Cost effective service-purchasing based on insured requirements Use of insurer-owned service providers to encourage competition The success of Managed Care in Switzerland will largely depend on the readiness of health care stake-holders to adapt, learn, and cooperate in a constructive, professional, and open-minded framework.

Cost Control↗
PubMed2001

Attenuation of hyperalgesia by LY235959, a competitive N-methyl-D-aspartate receptor antagonist.

N-methyl-D-aspartate (NMDA) receptor antagonists may be of value in the management of hyperalgesia. LY235959, a competitive NMDA receptor antagonist, at doses of 0.001 and 0.003 nmol, intrathecally (i.t.) blocked the hyperalgesia induced by 11.1 nmol of NMDA in rats prepared with a chronic i.t. cannula. However, LY235959 does not block the hyperalgesia produced by kainic acid (a non-NMDA glutamate receptor agonist) providing evidence of its selectivity for the NMDA receptor. Using the formalin nociceptive test, 0.001 nmol LY235959 (i.t.) significantly reduced the number of Phase 2 flinches by about 80%. LY235959 can also reduce the flinching in Phase 2 by 30% when given subcutaneously (s.c.) at the lowest dose which does not produce motor deficits (20 mmol/kg). Thus, LY235959 (i.t. or s.c.) has NMDA receptor antagonist activity as defined by its ability to prevent hyperalgesia and formalin-induced central sensitization. Moreover, it is a much more potent antihyperalgesic after i.t. as compared to s.c. administration.

Animals↗
PubMedDate not supplied

Monitoring health care in the United States--a challenging task.

Surveys have provided magnificent information about the health of the American people, but they rarely contribute to our understanding of how medical services affect people's health. The authors explore the opportunity to harness the medical services system to provide information that clarifies the relationship between people's health and the services they receive. They also note the risk posed by managed care-that competition and cost-cutting may pit the health industry against access to and standardization of health services data--but see hope in recent legislation.

Aged↗
PubMedDate not supplied

Managed care strategy.

Managed care is, in reality, managed payment delivered through exclusive price-competitive contracts that require healthcare providers to reorganize to participate as equals in the division of premium dollars.

Capitation Fee↗
PubMed2001

[Multidisciplinary management of the obese patient: example from the Obesity Center at the University of Liege].

Obesity is a mulfactorial disease whose prevalence is progressively increasing. Ideally, it requires a multidisciplinary management by medical doctors, dieticians, psychologists and kinetherapists. The new "Centre de l'Obésité" at the University of Liège aims at fulfilling such objectives with: 1) a first outpatient visit including the simultaneous participation of an endocrinologist, a dietician and a psychologist; 2) a structured and individualized programme of physical rehabilitation; 3) an individualized management of obese subjects as in-(hospital) and/or outpatients, using medical and/or surgical approaches; and 4) an opportunity to benefit of other specialized medical advices, if necessary, in order to increase both the efficacy and safety of the treatment. Owing to the increasing importance of obesity and the well-known difficulties to succeed in treating it, general practitioners should consider this new centre as a valuable help rather than a competitive structure for the management of their patients, especially those with severe or morbid obesity.

Counseling↗
PubMed1995

Managed care.

Explore the source record for details and available documents.

Economic Competition↗
PubMed2006

An analysis of the strategies for public hospitals.

Today, more than ever, the variables that define the health-care environment (demand, costs, system deregulation) are undergoing rapid change, thus obliging hospital administrators to develop and implement competitive strategies in order to survive in the increasingly competitive environment of hospital management. The primary objective of this paper is to identify strategies in a sample of Spanish public hospitals. Following this, we try to detect groups of organizations using similar strategies and ultimately analyse their influence on hospital performance.

Economic Competition↗