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Full-Text Articles in Medicine and Health Sciences
Utilization Review Software: The Impact On Productivity And Structural Empowerment In Case Management Nurses In An Acute Care Setting, Kimberly Frazier
Utilization Review Software: The Impact On Productivity And Structural Empowerment In Case Management Nurses In An Acute Care Setting, Kimberly Frazier
Nursing Theses and Capstone Projects
The Center for Medicare and Medicaid (CMS) seeks to achieve cost control by implementing aggressive cost containment mechanisms for an exploding Medicare population. One such mechanism is utilization review, which is employed to limit reimbursement of medical care that is determined to not be medically necessary. The CMS Conditions of Participation mandate that all hospitals determine whether a patient qualifies for an Inpatient or Observation stay. Utilization Review Specialist (UR) nurses were given the Conditions of Work Effectiveness Questionnaire II (CWEQ-II), Organizational Relationship Scale II (ORS-II), and the Job Activity Scale II (JAS II), six months after McKesson InterQual software …