Utilization Management (UM)

Ballymore’s comprehensive UM program can provide immediate reductions in inmate offsite health care costs as well as in related offsite transportation and security costs. We review offsite medical care throughout the course of each service:

• Prospectively, prior to an inmate’s inpatient stay or offsite specialty procedure;
• Concurrently, during an inmate’s inpatient hospital stay;
• Retrospectively, after an inmate’s ER visit or other emergency care.

Our physician-led UM program:

• Provides you with independent review of medical cases to help ensure cost-effective, clinically appropriate care;
• Supports your risk management program by removing causes for potential inmate litigation;
• Identifies and tracks trends in your offsite care utilization and costs;
• Generates scheduled, standard reports that allow you to compare your facility with regional and/or national benchmarks;
• Offers clinical expertise for compliance with ACA, NCCHC, and other accreditation standards.