The term “Utilization Management” was first heard in healthcare roughly three decades ago. The Institute of Medicine came up with a formal definition in 1989 that discusses “…techniques used by or on behalf of purchasers of health care benefits to manage health care costs…”. In plain English: It’s how health plans determine preauthorization.
Until very recently, with health plans the sole bearers of risk, Utilization Management couldn’t extend any further. It was about saving them money.
But not anymore. That definition is fast becoming outdated; we need a broader one.
Editor’s note: this blog post originally appeared on Medecision’s website.
To view the full blog post, click here.
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