Technology and outpatient review: a preliminary evaluation.

Area of Science:

• Health Services Research
• Health Economics
• Medical Technology Assessment

Background:

• Traditional cost-control programs often overlook outpatient services.
• Parkside Health Management Corporation introduced a new review program.
• This program targets specific high-technology and non-catastrophic treatments.

Purpose of the Study:

• To evaluate the pilot test of the Technology and Outpatient Review (TOR) program.
• To determine the impact of TOR on healthcare costs and utilization.
• To assess the appropriateness of care and patient satisfaction under TOR.

Main Methods:

• The study evaluates a pilot test of Parkside's Technology and Outpatient Review (TOR) program.
• TOR focuses on treatments and procedures in outpatient settings and specific inpatient services.
• Researchers are assessing cost, utilization, appropriateness, and patient satisfaction.

Main Results:

• The TOR program examines treatments accounting for approximately 6% of claims expenses.
• The pilot test aims to quantify the effects of this targeted review.
• Specific procedures reviewed include chiropractic, podiatric, physical therapy, C-section, endoscopy, ultrasound, and lithotripsy.

Conclusions:

• The TOR program represents a novel approach to healthcare cost and utilization management.
• Further evaluation is needed to confirm the program's effectiveness and impact on patient care.
• This targeted review may offer insights into managing costs for a specific segment of healthcare services.