Decisions made before and around complex MSK and cardiovascular procedures can influence recovery, avoidable utilization and other downstream outcomes that matter to health plans.
Due to fragmented and siloed care journeys, patients are not improving as efficiently and effectively as they could which often leads to negative downstream effects for all parties—payers, providers, and patients.
Focusing on the quality of care rather than the quantity of care delivered has become especially important in healthcare. Leaning on utilization management is a crucial component to achieving this “quality over quality” mentality.