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Utilization Review Issues
Utilization ... Days per 1,000 Admissions per 1,000 ALOS (Days) Medical 4% 17% 11% Surgical 3 11 10 Maternity 0 9 8 ... GUQTVQHQWVNKGTRTQXKUKQP CHART 1 DIRECTION OF UTILIZATION %NCKOUCDQXGCEGTVCKPCOQWPVYKNN ...Description: Presented at June 1996 Spring Meeting. This discussion looks at how a managed care plan can know whether it is doing a good job on utilization review, if there is room for further reduction in utilization, and how a plan should prevent under-utilization.
Hide- Authors: Wesley S Carver, Robert Dobson, Brent Greenwood, Zoe M McCarthy
- Date: Jun 1996
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance