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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 ...
Local disability theatre group. Social work management is the management of organisations or enterprises in the social economy and non-profit sector, e.g., public service providers, charities, youth welfare offices, associations, etc. [1] Social work management has been traditionally pursued by social workers, social pedagogues, pedagogues, psychologists without additional management skills ...
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.
A Personal practice model (PPM) is a social work tool for understanding and linking theories to each other and to the practical tasks of social work. Mullen [1] describes the PPM as “the art and science of social work”, or more prosaically, “an explicit conceptual scheme that expresses a worker's view of practice”. A worker should ...
The Andersen healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, the usage of health services (including inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing factors, enabling factors, and need.
Persuasive utilization is the enlistment of evaluation results in an effort to persuade an audience to either support an agenda or to oppose it. Unless the 'persuader' is the same person that ran the evaluation, this form of utilization is not of much interest to evaluators as they often cannot foresee possible future efforts of persuasion. [8]
URAC's accreditation programs include specialty pharmacy, digital health, utilization management, health plan, case management, and others. [4] In order to earn an accreditation, organizations submit various policies and procedures which are reviewed by a nurse or pharmacist and then the Accreditation Committee. [5] Accreditation lasts for ...
Aristotle's Rhetoric, renowned for its modes of persuasion in ethos, logos, and pathos, gave mankind its first recorded guide to and theory of social influence. Aristotle recognized that different appeals are necessary for different types of persuasion, and that these appeals can be tailored and refined to better suit the audience or better suit the product or idea at hand.