In which decade did case management and utilization review for medical necessity become more common in insurance pools?

During the 1980s, case management and utilization review processes began to gain significant traction within insurance pools, largely due to the escalating healthcare costs and the need for greater efficiency in resource allocation. This period saw a shift in the way healthcare services were delivered and reimbursed, prompting insurance companies to implement systematic methods for evaluating the necessity and appropriateness of medical services.

The rise of managed care during this decade played a pivotal role in standardizing utilization reviews and case management practices. Insurers started to develop more structured review protocols to ensure that healthcare services met certain criteria before coverage was approved. This allowed for a focus on preventive care and coordinated treatment plans, ultimately contributing to cost containment strategies.

Innovations in healthcare technology and a growing emphasis on evidence-based practices during this time also supported the integration of case management into insurance frameworks. Consequently, the 1980s became a foundational decade for these practices, setting the stage for their widespread adoption in the following years.