Day: May 12, 2023

Value-based care has a clear goal: to provide the highest-quality, most equitable patient care while controlling costs. As a growing number of hospitals and healthcare systems gravitate toward this care model, utilization management (UM) has emerged as a fundamental component to successful implementation.  Doctors are well equipped to identify the services a patient needs, but they need a partner who can ensure patients receive those services in the right setting for the optimal price. This is where UM nurses step in to be that collaborator.  UM nurses serve as a liaison between providers and payers. They review patient clinical records