Utilization management and healthcare reform.
The reform movement in healthcare is occurring in response to financial pressures on American business. The trend toward managed care with competition-based discounting and capitation contracts is likely to continue even if Congress does not enact healthcare reform legislation. Efficient management of resources with acceptable outcomes and customer satisfaction is becoming increasingly crucial. As cost-shifting options are reduced, accurate knowledge and management of resource consumption costs become critical to enable hospitals to assume the financial risks associated with competing in any future capitation area. Hospitals must consider altering their approach to utilization management and business as usual to survive these changes.
Tanner Medical Center, Carrollton, GA.
S B
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Jones
D003363:Cost Control; D017050:Episode of Care; D005377:Financial Management, Hospital / Q000379:methods*; D018166:Health Care Reform / Q000191:economics*; D017721:Hospital Costs; D008329:Managed Care Programs / Q000191:economics; D014481:United States; D014600:Utilization Review / Q000191:economics* / Q000379:methods