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In a value-based reimbursement environment, the utilization management (UM) process is critical to ensure cost effective care. UM must be a collaborative initiative, incorporating the case management department with physicians, nurses, and other ancillary departments. This program will focus on the role of UM in a value-based reimbursement environment, and review UM in today’s contemporary case management models.
Our experts will discuss best-practices for your work when providing the UM process in a hybrid environment, like UM for bundled payment patients versus the traditional commercial patient. Attendees will also be provided with tips and strategies for streamlining the UM process.
|- UM case management roles||- UM Regulations||- Value-based reimbursement UM|
|- Critical case manager roles||- Hybrid case management role||- Collaborative process|
|- CoPs||- 2 Midnight rule||- UM committee|
|- Post-acute care providers||- Observation service||- Nursing & ancillary service|
|- Alternative payment models||- Transitional Medicare UM||- Appeals coordinator case manager|
|- Commercial UM||- Bundled payment||And there's more!|