J Clin Outcomes Manage
Implementation of criteria sets to reduce inappropriate utilization of hysterectomy in a health plan
Hinkle AJ, Zhou Q, Gayron M
Abstract: Objective: To evaluate the effectiveness of using evidence-based criteria in managing medical utilization and reducing practice variation in hysterectomy. Methods: A program that required prior authorization for hysterectomy procedures based on meeting evidence-based criteria was implemented. Results: Two years after implementation of the program, a 25% reduction in network-wide hysterectomy rate and a 30% decrease in network-wide variation was observed. Conclusion: Implementing evidence-based guidelines removes many of the nonscientific drivers of utilization and is a useful tool to manage cost and quality
Reports from the Field
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