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
Seasonal scheduling is a way for physicians offices to adjust their schedules to make room for wellness exams during specific times of the year. Learn how to leverage this practice to increase patient satisfaction and quality outcomes.
Emergency department visits are expensive and can be avoidable. At-home care organizations can reduce encounters, save money, and improve outcomes.