The Modern Health Care System: An Overview

4/27/99


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Table of Contents

The Modern Health Care System: An Overview

Introduction to Health Care Policy Development: Politics, Business, and Law in Medicine

Medicine today ...

What’s Ahead?

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HCFA

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A Brief History of Managed Care

MCO Expansion

Unmanaged care is no longer affordable ...

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Diagnosis Related Group (DRG)

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Utilization Review

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CPT Coding

Outpatient Claims Processing

Audit

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Resource-Based Relative Value Scale (RBRVS)

RBRVS Formula

RBRVS

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Physicians are legally, ethically, and realistically responsible for the health care of their patients.

 Author: Elizabeth J. Wagner Di Prospero

Email: wagnerel@umdnj.edu