Health disparities have received plenty of attention lately, and for good reason. These differences, which exist among various groups in the United States, can affect everything from readmission rates to health outcomes and are often the result of environmental, social, and economic factors.
Patients who leave the hospital against medical advice are more likely than other patients to be readmitted to the hospital within 30 days, adding up to a sizable and costly problem, according to a study published June 11 in the Journal of the American Medical Association (JAMA) Network Open.
The novel coronavirus (COVID-19) pandemic has created challenges for case management departments. They must balance protecting the health of case management staff while maximizing productivity. In this new environment, departments are closely examining the role of the utilization review (UR) case manager.
Prior authorizations will be needed for certain hospital outpatient services starting on July 1, 2020. The change was made in the 2020 outpatient prospective payment system/ambulatory surgical center final rule. Hospitals are required to get prior authorization for the following five procedures: