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Utilization Management of Orthopedic Services by Fitzsimons Army Medical Center and Evans Army Community Hospital
Final rept. Jul 1992-Jul 1993
FITZSIMONS ARMY MEDICAL CENTER AURORA CO
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This study involves designing an integrated UM Program for orthopedic services for Fitzsimons Army Medical Center FAMC and Evans Army Community Hospital, Fort Carson, Colorado. Since Evans Army Community Hospital is the designated DoD lead agent or the Colorado Springs Health Services Area, the coordination of orthopedic services between Evans Army Community Hospital and the U.S. Air Force Academy Hospital is incorporated in this study. The use of prospective, concurrent, and retrospective reviews, cases management, discharge planning, and other UM tools which have been widely utilized in the civilian sector are reviewed. Staffing, workload, NonAvailability Statements NASS, supplemental care costs, partnership agreements, referral system, and UM practices as they pertain to orthopedic services are analyzed. This study provides FAMC with a strong foundation for designing a regional UM Program that can be applied to the other high CHAMPUS costs within FAMCs geographical areas of responsibilities. FAMCs graduate medical education GME mission and the importance of maintaining its vital patient referral base are also considered in this study. Utilization management program.
APPROVED FOR PUBLIC RELEASE