Bridging the gap between clinical practice and other sectors, this new resource challenges rehabilitation providers to think beyond treatment to disability management. It provides the theories and knowledge needed to effectively manage patients' disabilities within a managed care framework, with the goal of better collaboration with claims adjusters, case managers, risk managers, human resource personnel, safety and health officers, attorneys, peer reviewers, and others in the health care system. Highly visual and packed with useful information, it provides an excellent introduction to the wide variety of interested parties with whom a therapist will interact in the course of managing a client's health.The author has more than 23 years of experience consulting with insurance companies, employers, and the legal sector, and offers proven strategies for collaboration between providers and others involved with the health care system.Filled with numerous illustrations, graphics, and tables, many of which are useful for training and education of staff or clients.The appendix contains a large and diverse collection of helpful information that is not readily available from other sources. It also provides an essential list of resources for further reading about this constantly changing field.Chapters cover theoretical issues (management models, definitions of disability) as well as disability management in long-term care, worker's compensation, outcomes management, legal implications, and more.Case studies throughout the book present realistic examples of situations to improve the reader's technical and critical thinking skills.Focused on managing disabilities (i.e., functional problems) rather than on treating impairments (i.e., diseases), encouraging rehabilitation providers to think "out of the box" and to position themselves better within and beyond managed care.
Author(s): David Clifton
Edition: 1
Publisher: Saunders
Year: 2004
Language: English
Pages: 458
Cover......Page 1
Copyright......Page 2
Dedication......Page 3
Reviewers......Page 4
Contributors......Page 5
Foreword......Page 6
Preface......Page 8
Acknowledgments......Page 11
Disablement Models......Page 12
Disability Costs andDemographics......Page 24
Disability Management:Principles and Practices......Page 40
DisabilityManagement inLong-Term Care......Page 58
DisabilityManagementin Workers’Compensation......Page 80
Disability Management:An Insurer’s Perspective......Page 99
Confounding Obstaclesto Disability Management......Page 112
Disability Determinations......Page 128
Functional Capability Evaluation......Page 138
Utilization Review and Management......Page 153
Descriptive Study of Physical Therapy Case Management......Page 170
Information Technology in Disability Management......Page 178
The Quest for Quality in Health Care......Page 194
Outcomes Management......Page 211
How to Locate Sources of Disability-Related Data......Page 233
Risk Management......Page 243
Ethical Considerations in Disability Management......Page 250
Fraud and Abuse Prevention: Legislative and Regulatory Issues of Importance for Rehabilitation Providers......Page 265
Federal Reimbursement-Focused Statutes for Rehabilitation Providers......Page 271
Transition to Change in a Complex Health Care Sector......Page 285
Delivery Paradigm Shifts......Page 299
Chronicity: Rehabilitation’s New Horizon?......Page 320
Evolution of Managed Care......Page 333
Complementary and Alternative Health......Page 343
Beyond Managed Care: A Vision of the Future......Page 355
Profiles in Disability Management......Page 373
Consulting Opportunities for Rehabilitation Providers......Page 397
Appendix A - Government Sources of Disability Data/Information......Page 426
Appendix B - State Insurance Commissioners......Page 427
Appendix C - Foundations and Research Institutes......Page 429
Appendix D - Accreditation and Certification Bodies......Page 431
Appendix E - Associations/Organizations......Page 432
Appendix F - Coalitions and Consulting Companies......Page 435
Appendix G - Managed Care Models and Structures......Page 436
Appendix H - Useful Links and Additional Information......Page 437
Appendix I - Fact Sheets......Page 439
Appendix J - Glossary and Abbreviations......Page 444
Index......Page 448
