Managing utilization successfully in 12 not-so-easy steps.
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.
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Managed Care Education Institute for Healthcare Advancement, Whittier, CA, USA.
D019985:Benchmarking; D003284:Contract Services / Q000458:organization & administration; D017598:Efficiency, Organizational; D017408:Guidelines as Topic; D006295:Health Resources / Q000706:statistics & numerical data; D008329:Managed Care Programs / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D010934:Planning Techniques; D010818:Practice Patterns, Physicians'; D017064:Process Assessment, Health Care / Q000458:organization & administration*; D013597:Systems Analysis; D014481:United States; D014600:Utilization Review / Q000379:methods* / Q000458:organization & administration