How can a manager improve individual and population health and reduce the need for expensive, duplicative services?
Policy Definition: Care management programs apply systems, science, incentives, and information to improve medical practice and assist consumers and their support system to become engaged in a collaborative process designed to manage medical/social/mental health conditions more effectively. source
How can managers utilize structured treatment plans to help individuals better manage their chronic disease, maintain and improve quality of life, and reduce hospital costs?
Policy Definition: Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant. source
How do payers manage the use of health care services?
Policy Definition: Utilization management is a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision. source