Inappropriate Admissions Avoided: A Collaborative Approach

  • January 26, 2016
  • 1:00 PM – 2:00 PM ET
  • Online
about

McKesson318x177

Inappropriate Admissions Avoided A Collaborative Approach from AHIP on Vimeo.

Hear how one integrated systems’ innovative utilization management program uses evidence-based clinical guidelines to address inappropriate ED admissions at a hospital facing an over-capacity situation. The program resulted in the diversion of 100 inappropriate admissions in four months while seeing increased appropriate admissions. The program is now expanding to cover two other problem areas: imaging studies and molecular diagnostic testing. Using criteria to establish medical necessity, the plan aims to reduce unnecessary and duplicative testing in these two costly and fast-growing areas.

Inappropriate inpatient care abounds and leads to over utilization and increased costs for payers, providers, and members. Managing medical necessity is more important than ever with the shift from volume to value. Payers must collaborate with providers to ensure the highest quality and most appropriate care is given to members.

Inappropriate inpatient care abounds and leads to over utilization and increased costs for payers, providers, and members. Managing medical necessity is more important than ever with the shift from volume to value. Payers must collaborate with providers to ensure the highest quality and most appropriate care is given to members.

Webinar participants will learn:

  • How to identify areas of potential overutilization while at the point of Emergency Department encounter
  • A new approach to reduce inappropriate admissions and improve decision-making accuracy of location of care
  • How to collaborate with all providers (physicians, care managers, hospital administration) effectively

Who should attend: Payer representatives, health system representatives, hospital administration staff, inpatient care managers, and others interested in effective management of health care utilization.


Speakers:


Eugene Truchelut MD, Medical Director, Clinical Performance Department Florida Hospital Population Health Service Organization

Webinar Participants Will Learn:

How To

Identify areas of potential overutilization while at the point of Emergency Department encounter

A New

Approach to reduce inappropriate admissions and improve decision-making accuracy of location of care

How To

Collaborate with all providers (physicians, care managers, hospital administration) effectively