Commission for Case Manager Certification (CCMC) Exam 2026 – 400 Free Practice Questions to Pass the Exam

Question: 1 / 400

Utilization management is best described as:

A process focused on historical data review

A reactive approach to patient care

A forward-looking approach using evidence-based criteria

Utilization management is best described as a forward-looking approach using evidence-based criteria. This process entails evaluating the appropriateness of care and ensuring that patients receive necessary and appropriate services while preventing unnecessary treatments. By leveraging evidence-based criteria, utilization management aims to optimize care delivery and resource use, guiding the decision-making process towards evidence-supported interventions.

This proactive methodology supports healthcare providers in making informed decisions, ultimately enhancing patient outcomes and controlling healthcare costs. It involves assessing the needs of the patient before services are provided, aiming for an efficient healthcare delivery system. This forward-thinking stance is essential in a landscape where balancing quality care with cost-effectiveness is increasingly vital.

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A method of collecting patient feedback

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