Reducing Radiation Exposure from CT through UM

June 18, 2014

By: Mark D. Hiatt, MD, MBA, MS Purpose Exams that irradiate patients are common in today’s healthcare system. Although inadvertent, often exams are inappropriately or unnecessarily performed. This study evaluates the efficacy of utilization management (UM) in reducing unnecessary medical radiation. Methods The national health insurance plan studied covered...

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The Effect of a No-Denial Policy on Imaging Utilization

June 18, 2014

Purpose Seeking to control advanced diagnostic imaging costs, health insurance plans have instituted broad-based utilization management systems. Most processes ultimately contain denial provisions, meaning that the health plans will refuse to pay for requested studies if performed. The aim of this analysis was to determine whether removal of a...

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Radiology Benefits Management in the Era of Accountable Care

June 4, 2014

By: Mark D. Hiatt, MD, MBA, MS and Timothy R. Johnstad, MBA Background Popularized by their inclusion in the Patient Protection and Affordability Care Act, accountable care organizations (ACOs) may be for the coming decade what health maintenance organizations (HMOs) were during the 1970s. Like HMOs, ACOs are formed...

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