Medical necessity may be determined through cost-benefit analyses and risk-benefit analyses. Cost-benefit refers to the resource expenditures relative to potential medical benefits, while risk-benefit compares the potential undesirable outcomes/side effects with the potential for desirable outcomes.
Evaluate clinical decisions and services on the basis of:
These factors are based on the Triple Aim Initiative, developed by the Institute for Healthcare improvement as a framework designed to enhance health system performance.
Evaluate health outcomes and patient experiences by measuring your clinical outcomes. Before selecting a clinical outcome measure, answer the following questions:
Once you identify a potential measure, ensure that it is appropriate to answer your clinical practice question: