This book provides a complete explanation of the financing issues facing the managed care industry.

This edition features:

• Two chapters on risk adjustment methods Anthony Tucker, Jonathan Weiner, and Chad Abrams of Johns Hopkins University explore the tools for measuring health-based risk, applying diagnosis-based risk adjustment, and more. Melvin J. Ingber of the Centers for Medicare and Medicaid Services explores implementation of risk adjustment for Medicare.
• In-depth look at the Buyers Health Care Action Group (BHCAG) of Minnesota's Choice Plus program This discussion summarizes the results produced by Choice Plus and explores whether the program deserves consideration as a national model for healthcare reform.

  A brief history of the managed care industry is also provided, as well as valuable insights and projections for the future by Gordon Trapnell, a nationally recognized actuary.