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Managed Care
The growth in managed care in both the public and private sectors is
having a significant impact on the U.S. health care system. To assist
pediatricians and child advocates to respond to this growing trend effectively,
the American Academy of Pediatrics offers various resources and publications
through the Division of Health Care Finance
and Quality Improvement and the Committee on
Child Health Financing. The following resources, available through
the AAP BookStore,
can be seen as a toolbox of strategies and guidance materials to assist
pediatricians and families in understanding and challenging the demands
of managed care. With so many routes to take in managed care, these
resources will help guide pediatricians and families in the right direction.
- With over 200 pages of information, the manual " A
Pediatrician's Guide to Managed Care"(2nd edition) supplies
critical advice pediatricians can use immediately for negotiating
contracts, evaluating capitation rates, assessing physician organization
models, and clarifying legal issues. It includes the updated Model
Managed Care Agreement and a series of issue briefs on managed care
and children with special health care needs.
- The brochure " How to Use Your Managed Care Plan Effectively:
Questions and Answers for Families" (see
full text) is designed to be used by pediatricians to help families
understand the nuances of managed care. Using a question and answer
format, the brochure provides easy-to-understand explanations on a
variety of managed care policies and procedures.
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