Selection of Commercially Prepared Utilization Management Guidelines: A Delphi Study,
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATI ON
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The downsizing of the Department of Defense cuts across all branches of the military. Measurement of the effectiveness of the leaner fighting force is essential to allow decision makers to spend the shrinking military budget in the most cost effective manner. The medical departments of the three services have been included in this downsizing however, their missions have not been downsized. New methods and systems for the delivery of healthcare to military beneficiaries are being implemented. The evaluation of healthcare provided under the new delivery system is essential since the budget for healthcare is also being downsized. The quality and effectiveness of the care provided must continue at high levels while costs are kept as low as possible. The selection of utilization management UM guidelines for use in DoD medical treatment facilities has far reaching consequences. These guidelines are used to evaluate the care provided not only in the military hospitals and clinics, but also the care provided by the contracted provider networks. The selection of UM guidelines should be based on criteria selected by individuals with experience and expertise in utilization management. UM guidelines should not be selected based only on by the dollar amount attached to the contract. The rework that the selection of the wrong set of guidelines could cost would negate any perceived savings on the upfront cost of the contract.
- Economics and Cost Analysis
- Medical Facilities, Equipment and Supplies
- Administration and Management