Vendor speaks out on utilization management

Sunday, November 28 | 11:35 a.m.-11:45 a.m. | SSA11-06 | Room S403A
Clinical decision support can be viewed from two perspectives: self-administration by adherence to evidence-based guidelines, a process that can be standardized through the use of decision-support software; and utilization management by a third party, often also using decision-support software.

Mark Hiatt, MD, makes a case for utilization management by a third party. In a scientific session on the use of informatics to provide clinical-decision support, he presents a lesson in economics.

Hiatt, the chief medical officer of HealthHelp, a Houston-headquartered radiology benefits management company, will discuss how both macroeconomic theory and actions of a specialty benefits management company can lead to millions of dollars of cost savings by limiting inappropriate and/or redundant diagnostic imaging procedures.

Either method yields results: an approximate $100 million in savings over a five-year period.

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