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Utilization Review and Management: A Brief Analysis of a Growth Industry

Published online by Cambridge University Press:  21 June 2016

William B. Credè
Affiliation:
Departments of Quality Assurance, Yale-New Haven Hospital, New Haven, Connecticut
Walter J. Hierholzer Jr*
Affiliation:
Hospital Epidemiology, Yale-New Haven Hospital, New Haven, Connecticut
*
Medical Director, Department of Hospital Epidemiology, Yale-New Haven Hospital, New Haven, CT 06504

Extract

Inpatient hospital care consumes more than 30% of health insurance dollars regardless of the reimbursement mechanism, be it standarti fee-for-service, preferred provider organization (PPO), or health maintenance organization (HMO). It is understandable that reducing these costs has become the highest priority of health care purchasers, and that utilization review and management, the process of evaluating and attempting to reduce the cost of medical practice, has become a major growth industry with providers and purchasers of health care.

Type
Special Sections
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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