Managed care addresses the cost of providing healthcare benefits and delivering improved quality of care. Our health care lawyers represent managed care clients and health insurers in healthcare disputes and regulatory matters involving public and private sector healthcare benefits.
Utilization Management involves coordinating how much or how long care is given for each patient, as well as the level of care. The goal is to ensure care is delivered cost-effectively, at the right level, and doesn't use unnecessary resources. Tools include authorization requirements to approve services before they occur, concurrent review for continuing cases, and profiling of cases after they occur for analysis.