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Case Management and Utilization Review - An Opportunity For Strategic Gain
In the past several years, healthcare organizations have focused much time and effort on clinical documentation improvement and coding process revitalization, especially in preparation for the ICD-10 implementation deadline. Both of these areas have deep impact on their quality and financial outcomes. However, just as important, but often overlooked, are case management and utilization review (CM/UR). A number of regulatory initiatives, such as Value-Based Purchasing (VBP), continue to reinforce the importance of hospitals having a strong CM/UR function. Many healthcare provider leaders are beginning to take note of the impact CM/UR is having on financial and quality outcomes.