Using quality and efficiency evaluations of physicians.
Most physicians have long felt that there must be a better way to address the need for improving the cost effectiveness of medical care other than the process-heavy, invasive tactics of traditional UR. The QE strategy of replacing case-by-case pretreatment authorizations and certifications with a more thorough retrospective analysis of medical practice patterns appears to have the potential to dramatically improve managed care results while minimizing many of the more irritating aspects of traditional UR. The QE managed care strategy has much to offer the manager of a medical group practice who has come to realize the importance of demonstrating superior quality and efficiency as a way out of the "price discounting" game.
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Alexander
D004526:Efficiency; D008329:Managed Care Programs / Q000592:standards*; D008485:Medical Audit / Q000379:methods*; D008503:Medical Staff / Q000592:standards; D014481:United States; D014600:Utilization Review; D000078329:Workforce