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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 ...
Drug use/ utilization evaluation and medication utilization evaluations are the same as drug utilization review. [ 3 ] With the development of society and the economy, the costs of health care grows rapidly, and this becomes a burden on the worldwide health protection system. [ 4 ]
Raritan Valley Hospital, Green Brook, New Jersey [4] Riverdell Hospital, Oradell (closed 1981, demolished 1984) Senator Garrett W. Hagedorn Psychiatric Hospital, Lebanon Township; South Amboy Medical Center, South Amboy (now medical offices) Union Hospital, Union (remains open as a satellite emergency department "SLED")
Westchester Medical Center University Hospital (WMC), formerly Grasslands Hospital, is an 895-bed Regional Trauma Center [1] providing health services to residents of the Hudson Valley, northern New Jersey, and southern Connecticut. It is known for having one of the highest case mix index rates of all hospitals in the United States.
By increasing care coordination, ACOs were proposed to reduce unnecessary medical care and improve health outcomes, reducing utilization of acute care services. [16] According to CMS estimates, ACO implementation as described in the Affordable Care Act was estimated to lead to an estimated median savings of $470 million from 2012 to 2015.
Published annually since 1993, the Express Scripts Drug Trend Report provides detailed analysis of prescription drug costs and utilization. [20] [57] Now a web-based version, the Drug Trend Report is developed and published by the Express Scripts Research & New Solutions Lab with contributors from researchers, clinicians and others. [58]