Improving Outcomes in Utilization Management. Module E. Key Elem
The last module looks specifically at how good utilization can translate into better outcomes for patients while also lowering costs for a healthcare organization. First, it examines the sweet spot of healthcare—the right treatment at the right time—and how the concept of value-based purchasing can help hospitals track and achieve those outcomes. Next, the module uses a case study to explain how inefficient care can harm the patient and create costs for the hospital. It also details outcome measures, such as mortality, pressure ulcers and overall patient satisfaction. Last, the module shows how the proper licensure, credentialing and certification—such as from the Case Management Society of America (CMSA) and National Association of Social Workers—equips CMs to navigate the ever-changing healthcare system.