BALTIMORE, MD, May 31, 2019 – In managed care, medical management has traditionally meant working to determine best practices and services to improve both quality and outcomes. However, over the last decade or so, this term is being used more and more loosely and has been watered down at best.
The new Versant Health white paper—The benefits of true utilization management—discusses what medical management used to mean, how the term has become widely used and loosely interpreted, and what it means to truly provide medical (or utilization) management.
“Today, medical management can mean anything from true utilization management, the purest definition, to pre- and/or post-claim submission, steerage, or the ‘gatekeeper’ model,” explains Elizabeth Klunk, RN, BSN, CCM-R, Senior Vice President at Versant Health, and author of the white paper. “The result is a very common term that no longer lives up to its original definition.”
Versant Health believes true utilization management is a critical part of the managed care process. It helps support both members and providers efficiently and effectively by providing:
- Continuity of care
- Single source administration
- Peer communication
- Procedural consistency
- Evidence-based medical policy criteria application
- Medical claims review
- Seamless intra-practice care coordination
Learn more about what utilization management looks like in action. Download The benefits of true utilization management white paper from the Versant Health website today.