Blending utilization review with case management functions, utilization management closely monitors the quality of treatment provided, the use of benefits and the type and amount of treatment provided. The result is focus on quality and the most comprehensive method of controlling utilization and costs. The goal is a continuous focus on maintaining the patient in the least restrictive treatment modality and to involve the family and support systems. With early assessment and intervention, case managers can support the use of innovative treatment plans.

The program includes:

• Assessment and referral for treatment
• Pre-certification of treatment
• Case management of all care