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The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.
Mass General Brigham is a not-for-profit, integrated health care system that is a national leader in medical research, teaching, and patient care. It is the largest hospital-based research enterprise in the United States, with annual funding of more than $2 billion. The system's annual revenue was nearly $18 billion in 2022. It is also an educational institution, founded by Brigham and Women's Hospital and Massachusetts General Hospital. The system provides clinical care through two academic hospitals, three specialty hospitals, seven community hospitals, home care services, a health insurance plan, and a robust network of specialty practices, urgent care facilities, and outpatient clinics/surgical centers. It is the largest private employer in Massachusetts. In 2023, the system reported that from 2017–2021 its overall economic impact was $53.4 billion – more than the annual state budget.
The Tufts University School of Medicine is the medical school of Tufts University, a private research university in Massachusetts. It was established in 1893 and is located on the university's health sciences campus in downtown Boston. It has clinical affiliations with numerous doctors and researchers in the United States and around the world, as well as with its affiliated hospitals in both Massachusetts, and Maine.
Maine Medical Center is a 700-licensed-bed teaching hospital in Portland, Maine, United States. Affiliated with Tufts University School of Medicine, it is located in the Western Promenade neighborhood. It has a staff of over 9,500. The facility is one of only three Level I Trauma Centers in Northern New England. Founded in 1874, it is the largest hospital in northern New England with 28,000 inpatient visits, about 500,000 outpatient visits, 88,000 emergency visits, and over 27,000 surgeries performed annually. MMC is structured as a non-profit, private corporation governed by volunteer trustees. Maine Medical Center is wholly owned by, and serves as the flagship hospital for, MaineHealth, a non-profit healthcare network servicing Maine and New Hampshire.
Continuing medical education (CME) is continuing education (CE) that helps those in the medical field maintain competence and learn about new and developing areas of their field. These activities may take place as live events, written publications, online programs, audio, video, or other electronic media. Content for these programs is developed, reviewed, and delivered by faculty who are experts in their individual clinical areas. Similar to the process used in academic journals, any potentially conflicting financial relationships for faculty members must be both disclosed and resolved in a meaningful way. However, critics complain that drug and device manufacturers often use their financial sponsorship to bias CMEs towards marketing their own products.
Blue Cross Blue Shield Association, also known as BCBS, BCBSA, or The Blues, is a United States-based federation with 34 independent and locally-operated BCBSA companies that provide health insurance in the United States to more than 115 million people as of 2022.
The Massachusetts health care reform, commonly referred to as Romneycare, was a healthcare reform law passed in 2006 and signed into law by Governor Mitt Romney with the aim of providing health insurance to nearly all of the residents of the Commonwealth of Massachusetts.
New England Baptist Hospital (NEBH) is a 141-bed adult medical-surgical hospital in Boston, Massachusetts specializing in orthopedic care and complex orthopedic procedures. NEBH is an international leader in the treatment of all forms of musculoskeletal disorders and diseases.
The Lahey Hospital & Medical Center, formerly known as the Lahey Clinic, is a physician-led nonprofit teaching hospital of Tufts University School of Medicine based in Burlington, Massachusetts. The hospital was founded in Boston in 1923 by surgeon Frank H. Lahey, M.D., and is managed by Beth Israel Lahey Health. U.S. News & World Report has cited it several times on its list of "America's Best Hospitals" in the category of urology.
Founded in 1891, Lowell General Hospital is an independent, not-for-profit community hospital serving the Greater Lowell area and surrounding communities. With two primary campuses located in Lowell, Massachusetts, Lowell General Hospital offers a full range of medical and surgical services for patients. Lowell General Hospital is a member of the Voluntary Hospitals of America. Lowell General is affiliated with Tufts Children's Hospital in Boston.
MelroseWakefield Hospital is a 174-bed non-profit hospital located in Melrose, Massachusetts. MelroseWakefield Hospital and Lawrence Memorial Hospital of Medford function as one hospital entity with two campus locations. The MelroseWakefield Hospital campus provides many different areas of inpatient patient care including general surgery, interventional cardiovascular services, gynecology, maternity, special care nursery, orthopedics, and urology. It also offers outpatient care such as same day surgery, endoscopy, imaging and emergency services as well as serving as the region's Level III Trauma Center.
AcademyHealth is a nonpartisan, nonprofit professional organization dedicated to advancing the fields of health services research and health policy. It is a professional organization for health services researchers, health policy analysts, and health practitioners, and it is a nonpartisan source for health research and policy. The organization was founded in 2000, in a merger between the Alpha Center and the Association for Health Services Research (AHSR). In 2008, the organization had approximately 4000 health services researcher members.
Susan Dentzer an American health care and health policy analyst, commentator, and journalist. She is the President and Chief Executive Officer of America’s Physician Groups, the organization of more than 335 physician practices that provide patient-centered, coordinated, and integrated care for patients while being accountable for cost and quality. Until April 2022, she was a Senior Policy Fellow at the Robert J. Margolis Center for Health Policy at Duke University, located in Washington, DC. She was formerly president and chief executive officer of the Network for Excellence in Health Innovation (NEHI). Prior to NEHI she served as the senior policy adviser for the Robert Wood Johnson Foundation. She was the editor-in-chief of the journal Health Affairs.
Nehi or NEHI may refer to:
Henri A. Termeer was a Dutch biotechnology executive and entrepreneur who is considered a pioneer in corporate strategy in the biotechnology industry for his tenure as CEO at Genzyme. Termeer created a business model adopted by many others in the biotech industry by garnering steep prices— mainly from insurers and government payers— for therapies for rare genetic disorders known as orphan diseases that mainly affect children. Genzyme uses biological processes to manufacture drugs that are not easily copied by generic-drug makers. The drugs are also protected by orphan drug acts in various countries which provides extensive protection from competition and ensures coverage by publicly funded insurers. As CEO of Genzyme from 1981 to 2011, he developed corporate strategies for growth including optimizing institutional embeddedness nurturing vast networks of influential groups and clusters: doctors, private equity, patient-groups, insurance, healthcare umbrella organizations, state and local government, and alumni. Termeer was "connected to 311 board members in 17 different organizations across 20 different industries" He has the legacy of being the "longest-serving CEO in the biotechnology industry.
Eve Elizabeth Slater is an American physician who served as the United States Assistant Secretary for Health and Human Services under President George W. Bush from 2002 to 2003. Slater received her B.A from Vassar College in 1967 and M.D. from the Columbia University College of Physicians and Surgeons in 1971. She completed residency in internal medicine and fellowship in cardiology at the Massachusetts General Hospital, Boston, MA.In 1976, she was appointed the Chief Resident in Medicine at Massachusetts General Hospital, the first woman to appointed to this position. Dr. Slater is currently Professor of Clinical Medicine at Columbia Vagelos College of Physicians and Surgeons (P&S), where she has taught for over 35 years. She is board certified in internal medicine and cardiology and a fellow of the American College of Cardiology.(FACC). At MGH, she led the Hypertension Unit, as Assistant Professor of Medicine. Harvard Medical School.
Jeffrey Leiden is an American businessman who is the executive chairman of Vertex Pharmaceuticals, a biotechnology company based in Boston, Massachusetts. He was initially appointed to the board of directors of the company in 2009 and was CEO and president from February 2012 to March 2020.
Barry Keith Herman is an American board certified adult and child and adolescent psychiatrist, psychiatric administrator, and physician executive. He currently is Chief Medical Officer of Atentiv Health, a digital health specialty provider, since March, 2020. Immediately prior, he was Senior Vice President and Chief Medical Officer of Tris Pharmaceuticals, Inc. in Monmouth Junction, NJ. He left this position at Tris in January 2020. Herman's interests include psychiatric administration and management, healthcare policy, and psychopharmacological research. He has spoken and written frequently on the topic of physician leadership and management. He is the author of over 100 scientific abstracts and manuscripts, and is frequently quoted in the media. His psychiatric research has been widely cited. Herman is the Past President of the American Association of Psychiatric Administrators, and currently serves on its Executive Council. He is the recipient of the 2017 American Psychiatric Association Administrative Psychiatry Award.
Reshma Kewalramani, is the president and chief executive officer of Vertex Pharmaceuticals, a biotechnology company based in Boston, Massachusetts, as of April 1, 2020. She is the first female CEO of a large US biotech company. She was previously the chief medical officer and vice president of global medicines development and medical affairs at Vertex.
References
- ↑ "NEHI Goes Pure Acronym | CommonHealth". Commonhealth.wbur.org. 2011-01-18. Retrieved 2012-06-16.
- ↑ Building on a System of Outreach, Collaboration by Joshua Boger, Boston Globe May 7, 2007 , www.nehi.net
- ↑ "Valerie Fleishman". American City Business Journals . October 6, 2008.
- ↑ "The Economic Contributions of Health Care to New England" (PDF). Retrieved 2019-12-26.
- ↑ "Healthy People in a Healthy Economy: A Blueprint for Action in Massachusetts". Tbf.org. Retrieved 2012-06-16.
- ↑ "Member List". Network for Excellence in Health Innovation.
