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Utilization Review

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  • Topic: Utilization review
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Appropriate and Inappropriate Imaging Rates for Prostate Cancer Go Hand in Hand by Region, as if Set by Thermostat

April 1, 2012 | Journal Article

Policy-makers interested in containing health care costs are targeting regional variation in utilization, including the use of advanced imaging.

Utilization Management Can Negatively Impact Health Care Quality and Access

June 1, 1999 | Program Result Report

From 1992 to 1997, researchers at the University of Washington School of Public Health and Community Medicine evaluated the effects of utilization management on health care quality and access.

How Satisfied are Physicians and Patients When Medical Groups Control Access to Care?

April 1, 1997 | Program Result Report

The University of California, Los Angeles, School of Medicine examined how the structure and intensity of utilization management in physician groups with capitated contracts affect primary care physician and patient satisfaction.

Most Health Care Organizations Address Patient Safety Only Indirectly

July 1, 2004 | Program Result Report

From 2002 to 2003, research staff at URAC studied utilization management companies to learn how they use utilization management technology and processes to identify and manage potential patient safety problems.

Florida Develops Utilization Management System for Youth Mental Health Services

June 1, 2000 | Program Result Report

A 1996 legislative mandate directed Florida's Agency for Health Care Administration to develop a utilization management system for Medicaid-funded mental health and substance abuse services in order to achieve $34 million in savings.

Reducing Payment for Imaging in Referring Doctor's Facility Does Not Reduce Utilization

August 31, 1998 | Program Result Report

From 1994 to 1996, researcher teams at the University of Virginia and the Primary Care Outcomes Research Institute (PCORI) at the New England Medical Center conducted two distinct but parallel studies.

How Will Comparative Effectiveness Research Affect the Quality of Health Care?

February 1, 2010 | Issue Brief

Paper explores the potential impact of comparative effectiveness research and looks at implications for quality of care and health outcomes.

It's Spring and Allergy Season is Upon Us. Is our Primary Care Workforce Ready to Meet Patient Needs?

March 28, 2012 | Human Capital Blog Post

We are so pleased to be partnering with Ed Wagner, MD, MPH, Director of the MacColl Center for Health Care Innovation at Group Health Research Institute and Margaret Flinter, PhD, APRN, senior vice president and clinical director of the Community He ...

Post Claims Underwriting and Rescission Practices

January 1, 2009 | Report

Study details regulations and enforcement needed to fill gaps in protecting consumers in insurance markets.

New RWJF Program Will Study How to Use Primary Care Workforce More Effectively

March 8, 2012 | Human Capital Blog Post

The Robert Wood Johnson Foundation (RWJF) yesterday announced the launch of a new program designed to make primary care more accessible and effective by identifying practices that maximize the services of the primary care workforce. The Primary Care ...

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