Managing utilization successfully in 12 not-so-easy steps
Mayer, T.
Healthcare Financial Management Journal of the Healthcare Financial Management Association 52(10): 48; 50-52
1998
ISSN/ISBN: 0735-0732 PMID: 10187615 Document Number: 494097
Managing utilization involves managing the processes of care, which requires a system approach that coordinates services, eliminates redundancy in care delivery, and makes use of alternatives to traditional methods of meeting healthcare needs. On the caregiving level, internally developed benchmarks illuminate efficient or unneeded practice patterns, hospitalist programs help contain inpatient costs, and standard protocols and disease state management help to maintain expected measurable outcomes. Wisely managing patient access to care, relying upon case managers to oversee catastrophic care, assessing high-risk senior citizens and promoting their and other patients' relationships with social service agencies, and implementing patient education and prevention programs all can be coordinated within the managed care system.