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By Sarah Virgil

As reimbursements shrink and healthcare budgets grow tight, health systems are looking for ways to save money wherever possible. Many organizations are now turning to Utilization Committees to proactively manage and impact utilization throughout the network. Utilization strategies include:

  • Ensuring the right test is ordered at the right time, as well as making sure expensive pieces of equipment, such as x-ray machines, are not being over-used
  • Making sure that tests ordered by physicians are covered under specific coverage guidelines to maximize reimbursements
  • Focusing outreach activities and growth efforts based on historical ordering trends

An effective Utilization Committee requires a system of engagement that allows for transparency across the organization, provides clear-cut channels of communication, and gives the committee the ability to take action on goals. With a system of engagement and accountability in place, Utilization Committees can help healthcare organizations:

  • Create and track key performance indicators, such as repetitive tests, targeted tests for over-utilization, and tests per patient per day
  • Monitor inpatient activities, such as length of stay, admission diagnosis, or accommodation transfer details
  • Establish network-wide, evidence-based best practices and communicate with key stakeholders
  • Create custom alerts that notify the committee when a physician places an order for a test inconsistent with diagnosis standards set by the committee

To learn more about establishing a Utilization Committee in your healthcare organization, email or call 317-219-4646 today


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