Accession Number : ADA324185

Title :   Selection of Commercially Prepared Utilization Management Guidelines: A Delphi Study,

Corporate Author : ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATI ON

Personal Author(s) : Wyckoff, William J.

PDF Url : ADA324185

Report Date : MAY 1996

Pagination or Media Count : 70

Abstract : The downsizing of the Department of Defense cuts across all branches of the military. Measurement of the effectiveness of the leaner fighting force is essential to allow decision makers to spend the shrinking military budget in the most cost effective manner. The medical departments of the three services have been included in this downsizing; however, their missions have not been downsized. New methods and systems for the delivery of healthcare to military beneficiaries are being implemented. The evaluation of healthcare provided under the new delivery system is essential since the budget for healthcare is also being downsized. The quality and effectiveness of the care provided must continue at high levels while costs are kept as low as possible. The selection of utilization management (UM) guidelines for use in DoD medical treatment facilities has far reaching consequences. These guidelines are used to evaluate the care provided not only in the military hospitals and clinics, but also the care provided by the contracted provider networks. The selection of UM guidelines should be based on criteria selected by individuals with experience and expertise in utilization management. UM guidelines should not be selected based only on by the dollar amount attached to the contract. The rework that the selection of the wrong set of guidelines could cost would negate any perceived savings on the upfront cost of the contract.

Descriptors :   *FINANCIAL MANAGEMENT, *MILITARY MEDICINE, *HOSPITALS, *MILITARY DOWNSIZING, DEPARTMENT OF DEFENSE, MILITARY FACILITIES, DECISION MAKING, DATA MANAGEMENT, COST EFFECTIVENESS, ECONOMIC IMPACT, COST ANALYSIS, MANPOWER UTILIZATION, HOSPITALIZATIONS, PLANNING PROGRAMMING BUDGETING, MILITARY BUDGETS, DELPHI TECHNIQUES.

Subject Categories : Economics and Cost Analysis
      Medical Facilities, Equipment and Supplies
      Administration and Management

Distribution Statement : APPROVED FOR PUBLIC RELEASE