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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
The process of evaluation is considered to be a relatively recent phenomenon. However, planned social evaluation has been documented as dating as far back as 2200 BC. [4] Evaluation became particularly relevant in the U.S. in the 1960s during the period of the Great Society social programs associated with the Kennedy and Johnson administrations.
Patton has written many books on the art and science of program evaluation, including Utilization-Focused Evaluation (4th ed., 2008), in which he emphasizes the importance of designing evaluations to ensure their usefulness, rather than simply creating long reports that may never get read or never result in any practical changes. He has written ...
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.
The PRECEDE–PROCEED model is a cost–benefit evaluation framework proposed in 1974 by Lawrence W. Green that can help health program planners, policy makers and other evaluators, analyze situations and design health programs efficiently. [1]
Program process monitoring is an assessment of the process of a program or intervention. Process monitoring falls under the overall evaluation of a program. Program evaluation involves answering questions about a social program in a systematic way. Examples of social programs include school feeding programs, job training in a community and out ...
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) is the principal advisory group to the United States Secretary of the Department of Health and Human Services (HHS) on policy development and provides coordination and support for HHS's strategic and policy planning, planning and development of legislation, program evaluation, data gathering, policy-related research, and ...
The CIPP evaluation model is a program evaluation model which was developed by Daniel Stufflebeam and colleagues in the 1960s. CIPP is an acronym for context, input, process and product. CIPP is a decision-focused approach to evaluation and emphasizes the systematic provision of information for program management and operation. [1]