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INDEX
UNDERSTANDING MANAGED CARE CONSUMER PROTECTIONS MEMBER RESPONSIBILITIES QUESTIONS TO ASK YOUR PLAN QUESTIONS TO ASK YOUR PLAN: PEOPLE WITH SPECIAL HEALTH NEEDS BACKGROUND INFORMATION: NC HMOS HOW TO INTERPRET THE INFORMATION HMO COVERAGE OF SPECIFIC SERVICES COMMON EXCLUSIONS ENROLLMENT TRENDS DISENROLLMENT TRENDS UTILIZATION REVIEW INFORMATION FINANCIAL DATA GLOSSARY INTERNET RESOURCES INTERNET RESOURCES: INDIVIDUALS WITH DISABILITIES STATE FUNDED HEALTH PROGRAMS FOR YOUNG CHILDREN AND THEIR FAMILIES NC DEPARTMENT OF INSURANCE NC STATE EMPLOYEES HEALTH PLAN NC DEPARTMENT OF MEDICAL ASSISTANCE (MEDICAID) NC HEALTHCHOICE NC COUNCIL ON DEVELOPMENTAL DISABILITIES MEDICARE YOUR COMMENTS NORTH CAROLINA INSTITUTE OF MEDICINE |
![]() MANAGED CARE Internet Resources for the General Population The following list represents some useful internet websites that contain managed care information relating to the general population. Please let us know if you are aware of other appropriate websites. (Established in December 1989 as part of the U.S. Department of Health and Human Services. AHRQ is the lead agency charged with supporting research designed to improve the quality of health care, reduce its cost, and broaden access to essential services.) Main Website: Managed Care Research: http://www.ahrq.gov/research/mgdnote1.htm (501(c)(3) non-profit charitable organization founded in 1990 to establish standards for the managed care industry.) http://www.urac.org/ (Represents more than 1,000 HMOs, PPOs, UROs and other network based plans.) http://www.aahp.org/menus/index.cfm?CFID=35556&CFTOKEN=27089 (Nonprofit, nonpartisan association founded in 1958 dedicated to shaping and enriching the experience of aging for more than 30 million members and all Americans.) Managed Care Page: http://www.aarp.org/monthly/managedcare/home.html (Private, charitable foundation dedicated to helping build better futures for disadvantaged children in the U.S.) http://www.aecf.org/ (Founded in 1981, CBPP is one of the leading organizations in the country working on public policy issues affecting low-income families and individuals.) Health Publications Page: http://www.cbpp.org/pubs/health.htm (Established in 1995 as a non-profit, non-partisan policy and resource center affiliate with Princeton University.) Main Website: http://www.chcs.org/welcome.htm Link to Children's Issues in Managed Care: http://www.chcs.org/cimc.htm (a Project of the American Prospect Magazine) Health Policy Information: http://www.epn.org/ (National nonprofit, non-partisan organization dedicated to the achievement of high-quality, affordable health and long-term care for all Americans.) Managed Care Website: http://www.familiesusa.org/managedcare/ Link to Other Managed Care Websites: http://www.familiesusa.org/managedcare/resource.htm (Investigative arm of Congress that is charged with examining matters relating to the receipt and disbursement of public funds. GAO performs audits and evaluations of government programs and activities, including health-related programs.) http://www.gao.gov/ (Leading journal of health policy and managed care.) http://www.projhope.org/HA/ (Federal Agency that administers the Medicare, Medicaid and Child Health Insurance Programs.) Medicare and Medicaid Managed Care Page: http://www.hcfa.gov/medicare/mgdcar.htm Medicare Health Plan's Page: http://www.medicare.gov/managedcare.html Medicare Compare Database Page - interactive database that includes detailed information on Medicare's health plan options: http://www.medicare.gov/comparison/ (Nation's most influential advocate for private, market-based health care. Its 269 member companies provide health, long-term care, supplemental, and disability-income coverage to 115 million people - one out of two non-elderly Americans.) Consumer Information Page: http://www.hiaa.org/cons/cons.htm (The Center for Managed Care was established in May 1996 to assure that HRSA's programs and the underserved and vulnerable populations they serve are active and knowledgeable participants in managed care systems.) http://www.hrsa.gov/cmc/ (Independent health care philanthropy focused on four main areas: health policy, reproductive health, HIV policy, and health and development in South Africa. The Foundation also maintains a special interest in health policy and innovation in its home state of California and is not associated with Kaiser Permanente or Kaiser Industries.) http://www.kff.org/ (Independent, not-for-profit quality oversight body for health care organizations and managed care in the U.S.) http://www.jcaho.org/ (Leader in policy research and analysis on a variety of social policy issues such as welfare, education, health care, nutrition, employment, early childhood development, and other social policy areas.) http://www.mathematica-mpr.com/ (Provides resources to professionals and organizations interested in managed care.) Medicare Managed Care HMO Information Homepage: http://www.medicarehmo.com/mcmnu.htm (Non-profit, mutidisciplinary forum of and for state health policy leaders from the executive and legislative branches.) http://www.nashp.org/programs.htm (Private, non-profit organization that provides information that enables purchasers and consumers of managed health care to distinguish among plans based on quality) http://www.ncqa.org (Since 1975, NCSL has provided lawmakers and legislative staffers with information, research on critical state issues, publications, meetings and seminars, and a voice in Washington, D.C.) NCSL Health Issues Index - direct links to over 200 health care policy research studies and legislative tracking reports and more than 50 legislative briefs: http://www.ncsl.org/programs/health/list.htm (National public interest law firm that seeks to improve health care for America's working and unemployed poor, minorities, the elderly and people with disabilities.) Main Website: Link to Publications: http://nhelp.org/publications.shtml (NC state agency that regulates the managed care industry. Collects information on the operation of managed care plans in the state). http://www.ncdoi.com (National philanthropy established in 1972 is to improve the health and health care of all Americans. Today, RWJF is the largest US foundation devoted to health care.) http://www.rwjf.org/main.html (The Urban Institute investigates social and economic problems confronting the nation and analyzes efforts to solve these problems. The Institute seeks to increase Americans' awareness of important public choices and improve the formulation and implementation of government decisions. Much of its research is available to the public.) Health Policy Center: |