A managed care approach to outpatient review.
The recent growth in outpatient services has been the result of both increased use of new and improved technology, along with a shift to an ambulatory setting for many previously performed inpatient tests and procedures. Employers have seen an almost unchecked rapid growth in this portion of health care costs, with no signs of slowing down. This article attempts to show a basic step-by-step approach to identifying and reviewing some of the major cost generators through a managed care program.
Lawless
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Health Related Services, Inc., Pittsburgh, PA 15222.
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003363:Cost Control / Q000379:methods*; D003625:Data Collection; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D007345:Insurance Claim Review; D008329:Managed Care Programs; D010818:Practice Patterns, Physicians'; D014481:United States