Utilization Management Policies

Utilization management policies help reduce health care costs.

A health care institution‘s top leadership sets utilization management rules to reduce operating costs and ensure that personnel abide by corporate safety procedures when performing tasks. Utilization management also ensures that workers conform to laws and regulations.

Definition

Utilization management is a business practice that allows health care institutions to plan corporate financial and physical resources in accordance with business requirements and regulatory guidelines.

Quality Measurement and Improvement

Utilization management demands analytical skills and process improvement knowledge. Department heads assess quality levels in health care operating processes and remedy control weaknesses.

Orientation and Training

Orientation and training policies help health care workers familiarize themselves with the tools, procedures and techniques that professionals use to manage medical resources effectively.

Pre-certification Procedures

Pre-certification procedures are methodologies and policies that a health care institution follows when admitting new patients or validating the release of existing patients.

Inpatient Care Management

Inpatient care management requires interpersonal skills, service orientation and attention to detail. Inpatient care administration also demands that health care personnel possess effective communication skills.

Patient Discharge Planning

Patient discharge planning is an important part of utilization management because it helps a health care facility evaluate resource needs and allocate assets–such as beds and doctors–accordingly.