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  2. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]

  3. Case management (US healthcare system) - Wikipedia

    en.wikipedia.org/wiki/Case_management_(US...

    The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...

  4. Director of nursing (long-term care facility) - Wikipedia

    en.wikipedia.org/wiki/Director_of_nursing_(long...

    A director of nursing (DON) is a registered nurse who supervises the care of all the patients at a health care facility. [1] The director of nursing has special training beyond the training of a staff nurse for the position that pertains to health care management, and in some places, a director of nursing must hold a special license in order to be employed in that capacity.

  5. Health administration - Wikipedia

    en.wikipedia.org/wiki/Health_administration

    Iconographic Collections. Keywords: E. Walker; Florence Nightingale; W.J. Simpson. Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks in all the primary, secondary, and tertiary sectors.

  6. California Department of Managed Health Care - Wikipedia

    en.wikipedia.org/wiki/California_Department_of...

    The DMHC Help Center provides direct assistance in all languages to health care consumers through the Department’s website, www.HealthHelp.ca.gov, and a toll-free phone number, 1-888-466-2219. Mary Watanabe is currently the director of the DMHC. The DMHC is part of the California Health and Human Services Agency. It was established in 2000 ...

  7. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.

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