Analytical and Data-based Decision Making in Case Management Course
Analytical and Data-based Decision Making in Case Management Course is organized by Physicians Insurance - A Mutual Company.
Origination: Mar 2022
Expiration: Dec 2025
Description:
Data is being applied in ways never before seen by payers and providers to drive healthcare improvement through an analytic approach. Data can be applied to improve healthcare costs, quality, and outcomes. To understand how data is being utilized, you must first understand the broad perspective of what experts are calling the “data revolution” in healthcare, or the “age of big data.” It is also important to know what this means from a technology perspective. There is also a micro-level of healthcare data application within the payer setting that has different ways in which data is helping payers to improve overall population health, manage healthcare costs, and inform the creation of innovative pilot programs. For those working in a healthcare setting, it is important to know how healthcare data is applied from a payer’s perspective. This includes member case management selection, the intersection of healthcare data and member preference, and how data is being used to inform best practices through medical necessity criteria (MNC) and clinical guidelines.
Learning Objectives:
• Discuss the background and implications of big data in healthcare.
• Describe how data is utilized by case managers within different areas of the payer setting to improve care outcomes, measure case management performance, and identify fraud,
waste, and abuse.
• Explain how data drives better healthcare through evidence-based decision-making, application of medical necessity criteria, and utilization management.
Additional Details Will Be Posted as Soon as Information is Available.