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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 ...
t. e. The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving ...
Merative. Merative L.P., formerly IBM Watson Health, is an American medical technology company that provides products and services that help clients facilitate medical research, clinical research, real world evidence, and healthcare services, through the use of artificial intelligence, data analytics, cloud computing, and other advanced ...
Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [1][2] A discipline-specific process may be referenced accordingly (e.g., physician peer review, nursing peer review). Today, clinical peer review is most ...
Healthcare Cost and Utilization Project. The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
private pharmaceutical management company. Drug utilization review refers to a review of prescribing, dispensing, administering and ingesting of medication. [1] This authorized, structured and ongoing review is related to pharmacy benefit managers. [2] Drug use/ utilization evaluation and medication utilization evaluations are the same as drug ...
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