Utilization Management

Question

The book discussed utilization management primarily from a theoretical side. This podcast gives you some practical insights, mainly from the hospital’s point of view.

Watch the podcast: https://www.youtube.com/watch?v=853TVAWYdnQ

The guest in the podcast show tells us why utilization management is important by giving examples of problems that could happen in the real world.

List any two problems that she discussed and in your own words elaborate on them. The “CMS” that the guest is referring to is the payers– Medicare and Medicaid.

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