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Managing the Risks of Managed Care

Author(s): Barbara J. Youngberg, JD, BSN, MSW, FASHRM, Visiting Professor of Health Law and Policy, Loyola University Chicago College of Law, Chicago, Illinois
Details:
  • ISBN-13: 9780834207325
  • ISBN-10:083420732X
  • Looseleaf    275 pages      © 1996
Price: International Sales $397.95 US List
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Overview

The dominance of managed care is spreading quickly and risk managers are suddenly faced with major new challenges. With Managing the Risks of Managed Care, the risk manager will learn about risk management challenges in an integrated delivery system and presents expert analysis on issues like contracting, peer review, ethical dilemmas, antitrust and more.

ShowTable of Contents

Contributors
Introduction
Part I--Overview
Chapter 1.  An Overview of Managed Care
Chapter 2.  The Risk Manager's Role in the Integrated Delivery System

Part II--Strategic Issues
Chapter 3.  Risk Management for Strategic Planning for a Changed Health Care Delivery System
Chapter 4.  Developing Tools to Identify and Manage the Risks of Managed Care
Chapter 5.  Legal Issues Associated with the Use and Development of Practice Guidelines
Chapter 6.  The Physician As Gate-Keeper: What Are the Risks?

Part III--Legal Issues
Chapter 7.  The ERISA Preemption
Chapter 8.  Anti-Trust Issues in Managed Care
Chapter 9.  Legal Risks of Managed Care
Chapter 10. COBRA Risks and Managed Care
Chapter 11. Managed Care Contracting
Chapter 12. Tort Reform Initiatives and Managed Care

Section IV--Risk Transfer and Risk Finance
Chapter 13. Risk Financing Issues Facing Medical Providers
Chapter 14. Capitation and Stop-Loss Insurance
Chapter 15. Insurance Products to Minimize the Financial Risk of Managed Care

Section V--Other Issues in Managed Care
Chapter 16. Marketing Risks Associated with Managed Care
Chapter 17. Credentialing Issues and Managed Care
Chapter 18. Ethics, Accreditation, and Managed Care
Chapter 19. Managing the Data Needs for Managed Care

Index


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ShowAbout the Author(s)

Barbara J. Youngberg, JD, BSN, MSW, FASHRM-Visiting Professor of Health Law and Policy, Loyola University Chicago College of Law, Chicago, Illinois

Barbara Youngberg, JD, BSN, MSW, FASHRM has over 25 years experience helping academic medical centers and other complex healthcare organizations restructure quality, risk management, and patient safety programs to meet current needs and challenges.  During her 25 year career at University HealthSystem Consortium (UHC) she analyzed malpractice data and trends, quality and patient safety data, and best practice information to assist members in finding creative solutions to difficult risk and patient safety problems. As the Vice President of Insurance, Risk, Quality and Legal Services and co-lead of UHC’s Patient Safety Net (PSN), Ms. Youngberg helped to develop a Web-based reporting tool utilizing standardized language to allow of analysis of events and their root causes and worked to help members integrate patient-safety activities into existing quality and risk-management structures.  Often these efforts including helping members understand the way in which the legal climate could help or hinder them in their efforts.

Ms. Youngberg is a graduate of DePaul University College of Law (JD), University of Illinois–Jane Addams School of Social Work (MSW) and Illinois Wesleyan University (BSN).  She is presently a Visiting Professor of Law at Loyola University Chicago, Beazley Health Law Institute and helps to develop online curriculum for online health law MJ and LL.M degrees.  She is also a professor of Law for Concord Kaplan University School of Law and serves on the Board of Directors of the National Patient Safety Foundation.  She is the author of numerous articles and textbooks on quality management, risk management, and patient safety. 

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