The principal objective of utilization management is the reduction of practice variations by establishing parameters for cost-effective use of health care resources. There are four main techniques or tools used in utilization management: demand management, utilization review, case management, and disease management. Utilization management helps MCOs control costs and improve quality.
The principal objective of utilization management is the reduction of practice variations by establishing parameters for cost-effective use of health care resources. There are four main techniques or tools used in utilization management: demand management, utilization review, case management, and…