Case

Utilization Management

Assignment Overview

Please view the following video:

Utilization Review Committee - Resource Management Operations:
https://www.youtube.com/watch?v=6vpUB6HCnrM

The value of utilization management and review has been debated among the leaders in health care since its inception. For this module's case assignment, you are going to engage in the review of a utilization management plan for a health care organization.

Assignment Expectations

Search the Internet for a hospital or other health care organization's utilization management plan. Once you have found one, prepare a 4- to 6-page paper. (This does not include the title or reference page) in which you address the following:

• Identify the organization you researched and include the URL for the page of the utilization management plan that you examined.
• Provide an overview of the organizations utilization management plan- specifically, discuss each of the elements of the plan and describe how each of the elements contributes to health care quality.
• Identify two weaknesses of the organizations utilization management plan and describe "why" you consider them to be weaknesses. Postulate ways in which the weaknesses can be overcome.