Enhancing utilization review program results.
Utilization review programs are increasing in number and type, but their true contributions to payers' health care and cost management efforts vary tremendously, according to evaluations of over 100 private UR firms by National Medical Audit. Three senior executives of that firm discuss state-of-the-art criteria and methods for gauging the effectiveness of a UR program.
D005069:Evaluation Studies as Topic; D006761:Hospitals / Q000706:statistics & numerical data*; D007902:Length of Stay; D008330:Management Audit; D011366:Professional Review Organizations / Q000592:standards*; D014481:United States; D014600:Utilization Review / Q000592:standards*