Utilization Management

To influence effective patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision, utilization management will undoubtedly become a vital practice for physicians as they shift from volume-based to value-based care.

Subsero Health’s expertise resides in the day-to-day functions that are difficult to manage within a regular medical practice, like helping with authorization and referrals, helping with retrieval of other care information that could be provided to a doctor, and then help providing that information to the doctor at the point of care. A typical example would be a physician who sees a patient four times in a year. There are actions that are happening in between those visits. We help to gather that data and bring it into the following visit to make it actionable and usable for both the patient and the provider. We speak with the patient to help gather their thoughts, to help their family understand what’s going on, as well as feed that information to the doctor so that when the doctor has the visit, the visit is more effective.