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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 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 ]
Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. [1] In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012.
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).
The California Labor and Workforce Development Agency (LWDA) is a cabinet-level agency of the government of California.The agency coordinates workforce programs by overseeing seven major departments dealing with benefit administration, enforcement of California labor laws, appellate functions related to employee benefits, workforce development, tax collection, economic development activities.
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.
For example, California's Public Health Care Systems are only 6% of the hospitals in the state, yet provide care for 38% of all hospital care of uninsured in California- 123,000 of which are homeless, and 3.6 million of which live below the federal poverty line. [17]
A performance appraisal, also referred to as a performance review, performance evaluation, [1] (career) development discussion, [2] or employee appraisal, sometimes shortened to "PA", [a] is a periodic and systematic process whereby the job performance of an employee is documented and evaluated. This is done after employees are trained about ...
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