Controlling costs and changing patient care the role of utilization management institute of medicine division of health care services committee on utilization management by third parties marilyn j field and bradford h gray editors p cm includes bibliographical references isbn 0 309 04048 5 isbn 0 309 04045 0 pbk 1. Utilization management um has become a strong trend in health care cost containment under um some decisions are not strictly made by the doctor and patient alone instead they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. Systematic evidence about the impact of utilization management methods on the quality of care and on patient and provider costs both economic and noneconomic is virtually nonexistent purchasers have not demanded such evidence and researchers have found the measurement of these effects more costly time consuming and uncertain than measuring effects on purchasers costs. Genre form electronic books additional physical format print version staff institute of medicine controlling costs and changing patient care the role of utilization management. Author institute of medicine us committee on utilization management by third parties title controlling costs and changing patient care the role of utilization management institute of medicine division of health care services committee on utilization management by third parties bradford h gray and marilyn j field editors