Application: Utilization
Management and Models of Care
Health care providers and
other interested parties must continuously look for ways to manage limited
resources while improving quality and promoting patient safety. Utilization
management is intended to “make sure that health care is delivered in the
most efficient and effective manner for the patient and the population, where
such activities directly impact the quality of outcomes” (Pelberg in
Varkey, p. 145). The utilization management process bridges clinical,
financial, and administrative functions.
Within traditional health care
settings, utilization management can have a significant impact on the delivery
of services. In addition, various models of care are emerging that may help
transform health care delivery to achieve the aims of utilization management
and quality improvement.
To prepare for this
Application:
· Review the information on utilization management in
Chapter 7 ofMedical Quality Management.Also conduct additional research
using the Walden library and credible Web sites (some of which are listed under
Optional Resources).
· Analyze the Chronic Care Model and the
Patient-Centered Medical Home Model. How might these models be beneficial for
providing care to patients, especially those with multiple medical conditions?
· Identify the elements of each of these models, and
evaluate which may be most significant for achieving quality and safety goals.
Consider each of the six dimensions of quality identified by the Institute of
Medicine.
· Reflect on how these models should be structured in
order to achieve the best medical outcomes for individual patients at the
lowest cost to society.
The Assignment
Write a 2- to 3-page paper that addresses the following:
· Compare and contrast the Chronic Care Model and the
Patient-Centered Medical Home Model.
· Evaluate which elements of these models may be most
significant for achieving quality and safety goals.
· Explain how these models should be structured in
order to achieve the best medical outcomes for individual patients at the
lowest cost to society.
This Application is due
by Day 7 of this week.
Your written assignments must follow APA guidelines. Be sure to support your
work with specific citations from this week’s Learning Resources and from
additional scholarly sources as appropriate. Refer to the Essential
Guide to APA Style for Walden Students to ensure that your in-text
citations and reference list are correct.
Submit
your assignment by Day 7.
