Utilization Management as a Value-Based Care Strategy
At its core, utilization management analyzes trends in healthcare service use. It determines if these services comply with best practices and clinical guidelines. Traditionally, Utilization management (UM) was viewed primarily as a cost-control measure rather than a tool for enhancing service quality.
The value-based care strategy requires connecting a patient's health ecosystem, which includes primary care, specialty clinics, and payers. Discrepancies in this ecosystem have a significant...