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Cover image of Specialty Care in the Era of Managed Care
Cover image of Specialty Care in the Era of Managed Care
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Specialty Care in the Era of Managed Care

Cleveland Clinic versus University Hospitals of Cleveland

John A. Kastor, M.D.

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Limiting the use of specialists is one of the highest priorities of managed care, which requires patients and their primary care physicians to focus on a health maintenance approach. Preventive medicine programs, encouraged by insurers and HMOs, theoretically reduce the need for expensive specialty care and thus lower overall costs. But where does this leave specialists and their institutions?

Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland Clinic and the University Hospitals of Cleveland, to learn what these institutions are doing to survive in the current...

Limiting the use of specialists is one of the highest priorities of managed care, which requires patients and their primary care physicians to focus on a health maintenance approach. Preventive medicine programs, encouraged by insurers and HMOs, theoretically reduce the need for expensive specialty care and thus lower overall costs. But where does this leave specialists and their institutions?

Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland Clinic and the University Hospitals of Cleveland, to learn what these institutions are doing to survive in the current era. Using the findings of more than two hundred interviews with physicians, administrators, investigators, and trustees, the author describes in detail these rival organizations, their individual struggles against the economic pressures presented by managed care, and their sometimes bitter competition for patients.

The insights that emerge from this struggle will be of value to anyone interested in how high-profile hospitals and academic medical centers operate, particularly in economically and socially challenging situations.

Reviews

Reviews

A book that sprinkles tantalizing tidbits and provides a clear-eyed view of the inner workings of Cleveland's influential medical institutions.

A truthful and probing account... This book should be required reading for the next class of Leadership Cleveland.

Kastor has provided us with a meticulously researched case study whose lessons provide for a better understanding of the challenges facing all in the health care field.

Meticulously researched and documented case study... Kastor's book is indispensable.

Kastor has created a very unique window on our era of hospitals in a time of transition. An intriguing and highly important work.

About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
288
ISBN
9780801881749
Illustration Description
24 halftones
Table of Contents

Preface
Chapter 1. Cleveland and Its Medical Centers
Chapter 2. Cleveland Clinic: The Clinical Factory
Chapter 3. University Hospitals of Cleveland: Turmoil in University Circle
Chapter 4. University

Preface
Chapter 1. Cleveland and Its Medical Centers
Chapter 2. Cleveland Clinic: The Clinical Factory
Chapter 3. University Hospitals of Cleveland: Turmoil in University Circle
Chapter 4. University Hospitals of Cleveland: The Farah Walters Years
Chapter 5. University Hospitals of Cleveland: New Leaders
Chapter 6. The New Medical School
Chapter 7. Conclusions
Appendix 1: Interviewees
Appendix 2: Hospitals in Cleveland and Cuyahoga County in
1990 and 2004
Notes
Index

Author Bio
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John A. Kastor, M.D.

John A. Kastor, M.D., a professor of medicine at the University of Maryland School of Medicine, is the former chief of the Cardiovascular Division at the University of Pennsylvania School of Medicine and former chair of the Department of Medicine at Maryland. He is the author of Arrhythmias; Mergers of Teaching Hospitals in Boston, New York, and Northern California; Governance of Teaching...
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