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. An historical overview and a discussion of taxonomy and functional differences between different forms of managed health care provide the framework for the operational aspects of the industry as well.

Features and Benefits:

- New contributors.

- New chapter on the Patient Protection and Affordable Care Act of March 2010.

- New chapter on enrollment and billing.

- New chapter on fraud and abuse.

- Completely re-written chapter on information systems and electronic data interchange.

- Completely re-written chapter on Medicaid Managed Health Care.

- Complete restructuring of section 2 with a new focus on structure and payment across all types of health care delivery systems.

- New chapter on physician practice behavior and managed health care