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Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
Rheumatoid arthritis; A hand severely affected by rheumatoid arthritis. This degree of swelling and deformation does not typically occur with current treatment. Specialty: Rheumatology, Immunology: Symptoms: Warm, swollen, painful joints [1] Complications: Low red blood cells, inflammation around the lungs, inflammation around the heart [1 ...
The biologic agent rituximab (anti-B cell therapy) is now licensed for use in refractory rheumatoid arthritis. [9] Physiotherapy is vital in the treatment of many rheumatological disorders. Occupational therapy can help patients find alternative ways for common movements that would otherwise be restricted by their disease.
Jan. 18—ROCHESTER — Mayo Clinic announced a 2% salary raise for 2022 with a 2.75 multiplier, which is less than many companies are offering in the face of staff shortages and rising inflation.
As the largest single purchaser of medical services in the U.S., Medicare's fixed pricing schedules have a significant impact on the market. These prices are set based on CMS' analysis of labor and resource input costs for different medical services based on recommendations by the American Medical Association. [35]
Post-traumatic arthritis is a form of osteoarthritis and the former can occur after the latter. However, post-traumatic arthritis can also occur after the development of chronic inflammatory arthritis. Generally, post-traumatic arthritis is classified in two groups: post-traumatic osteoarthritis and post-traumatic inflammatory arthritis. [2]
Inflammatory arthritis is a group of diseases which includes: rheumatoid arthritis, psoriatic arthropathy, inflammatory bowel disease, adult-onset Still's disease, scleroderma, juvenile idiopathic arthritis, and systemic lupus erythematosus (SLE).
While managed care techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S., but has attracted controversy because it has had mixed results in its overall goal of controlling medical costs. [2]
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