Information and informational access is critical in optimizing utilization in healthcare
By Jay I. Pomerantz, MD – Executive Medical Director for Health Integrated

As I have shared with you the last couple of weeks, utilization management (UM) is a key to achieving the top goals in healthcare reform – improving patient outcomes while reducing overall cost. The interactions between the physician and the patient are a critical part of the process, particularly in a time where information is free flowing and readily accessible. Both physicians and patients have access to more data than ever before, and it has the potential to help steer and navigate decisions. (more…)

All of the stakeholders have a responsibility and thus will share in the clinical and financial benefits as utilization is optimally managed
By Jay I. Pomerantz, MD – Executive Medical Director for Health Integrated

Newsflash – healthcare costs keep rising.

No surprise there. It is also no surprise that payors will have to take the lead in bending the cost curve if we are to both continue to improve the quality of care and reduce the associated costs. It makes sense since they are the one link between all of the stakeholders in healthcare’s macro environment. In the past, the burden of increased healthcare costs could be pushed to the employer. 2009 figures show that on average, corporations will spend $9,552 per employee for health benefits, up 6% from 2008[1]. But the current economic situation has exacerbated a more aggressive stance taken by the employer in their relationship with payors. (more…)

Optimum utilization management is best driven through evidence-based medicine which is fed by vast and readily-accessible patient data
By Jay I. Pomerantz, MD – Executive Medical Director for Health Integrated

When you stop and think about the available tools and resources for clinicians today, it is somewhat mind boggling. The clinical resources and study data, ready access to health records, vast networks of physicians from general through specialty and so many other resources are available. For a clinician, these resources are augmented with a more sophisticated patient population who also has access to much broader medical and healthcare databases than any time in history. (more…)