Utilization management is described as the implementation of guidelines that reduce the unnecessary use of medical resources (Kongstvedt, 2007, p.190). There are various methods used to ensure that costs remain at a minimum without compromising patient care. The use of utilization management (UM) generates financial benefits, which incentivize managed care organizations (MCOs) and facilities to invest more in UM programs. Health maintenance organizations' (HMO) use of the primary care physician (PCP) as a "gatekeeper" initially had MCOs viewing the restrictions as a negative approach to patient choices. However, some necessary measures have started to be implemented to reduce unnecessary usage by applying certain restrictions. UM's applications and tools include: Demand Management (DM), this refers to a health plan's various approaches to ensuring that the most effective and necessary plan of care is provided to a patient. MD may be provided by health plans in the form of a nurse. advice lines. This tool has always been available with the majority of HMO plans. It is staffed by nurses available to answer members' questions 24 hours a day, seven days a week. This service is now emerging with PPOs, Medicare and Medicaid among others. This benefits the member by reducing trips to the emergency room due to conditions that could easily be treated on a non-urgent basis (Kongstvedt, 2007, p.192). Nurses play a vital role in UM, a study by Jencks, Williams, and Coleman (2009) showed that Medicare spent approximately $17.4 billion on beneficiaries readmitted within 30 days of discharge. An additional study by Bobay, Yakusheva, and Weiss (2011) suggested that the increase in nursing staff before the end of the article......tKongstvedt, PR (2007). Essential Elements of Managed Health Care. (5th ed.). Sudbury, MA: Jones & Bartlett Publishers. Radzwill, M.A. (2002). Integrating case and disease management: why and how?. Disease Management and Health Outcomes, 10(5), 277-289. Retrieved from EBSCOhostWickizer, TM and Lessler, D. (2002). Usage management: issues, effects and future prospects. Annual Review of Public Health, 23(1), 233. Retrieved from EBSCOhostBobay, KL, Yakusheva, O., & Weiss, ME (2011). Outcome and cost analysis of the impact of unit-level nurse staffing on postdischarge utilization. Nursing Economics, 29(2), 69-87. Retrieved from EBSCOhost Jencks, SF, Williams, MV, & Coleman, EA (2009). Rehospitalizations among patients in the fee-for-service Medicare program. New England Journal of Medicine, 360(14), 1418-1428. doi:10.1056/NEJMsa0803563