Case Management & Utilization Management Program Design
As patient needs grow more complex, Case Management and Utilization Management are essential to delivering evidence-based care, improving patient satisfaction, and strengthening the financial performance of healthcare organizations.
Our clinical and operational experts review the current program and then partner with clients to redesign structures and processes to ensure patients receive the right care, at the right time, in the right setting – driving optimal outcomes and appropriate reimbursement. By improving interdisciplinary communication and the coordination of care, we help client teams shift from a reactive to proactive mindset to achieve better resource utilization, interdisciplinary integration, and consistent high quality of care. Our implementation and change management solutions move organizations from a hospital-based function to one that provides care management across the continuum.
Related insights
Care meets payment: Teaching hospital dramatically reduces medical necessity denials across payers
When medical necessity denials doubled, leaders developed a proactive plan for denial prevention. It’s paying off. We share how.