What type of analysis does Utilization Review NOT typically include?

Utilization Review primarily focuses on evaluating the appropriateness and necessity of healthcare services. The typical methodologies involved in this process include prospective, concurrent, and retrospective analyses.

Prospective analysis occurs before the service is provided, assessing whether the proposed healthcare intervention is appropriate based on established criteria. Concurrent analysis takes place during the delivery of services, monitoring and ensuring that the care being provided aligns with treatment guidelines and is necessary in the moment. Retrospective analysis happens after the service has been rendered, reviewing the medical records and outcomes to determine if the care was appropriate and to identify any areas for improvement.

Financial analysis, however, does not align directly with the primary focus of Utilization Review, which is more concerned with clinical appropriateness rather than solely examining the costs or financial implications of care. While understanding the financial aspects of healthcare can be important in broader organizational management, it does not fall under the typical activities of a Utilization Review process which concentrates on quality and efficiency of care delivery. This differentiation clarifies why financial analysis is not a type typically included in Utilization Review.