Concurrent Review

The concurrent review takes place while the patient is receiving care while admitted to a facility. The purpose of the concurrent review is to put an oversight process in place that permits the scrutiny of the type of care being delivered, the necessity for that care, and the level and setting of that care. The goal is to ensure the delivery of efficient and effective health care, to reduce the misuse of inpatient services, and to promote high quality and safe patient care during the inpatient component of the care. Similar to prior authorization, the concurrent review can also facilitate communication about the patient to other components of the health care organization which permits quality monitoring, provides access to additional services and supports and may assist with the coordinate of care especially around transitions to the next appropriate level of care, which may be discharged to home or to a setting that delivers a lower level of care. The concurrent review can identify patients who could benefit from case management, disease management, or form a variety of population health strategies for their specific diagnosis or clinical situation. The concurrent review also uses sets of criteria, often based on national standard-setting efforts. Source: Giardino AP, Wadhwa R. Utilization Management. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK560806/](https://www.ncbi.nlm.nih.gov/books/NBK560806/)