Final answer:
Utilization review firms are designed to control healthcare expenditures by requiring providers to gain pre-approval for patient care to manage costs and prevent unnecessary medical procedures. These regulatory measures are aligned with the Affordable Care Act's goals to control escalating healthcare costs.
Step-by-step explanation:
The utilization review firms developed to control the expenditure of insurance funds require providers to seek approval before the delivery of care. These firms are integral to health maintenance organizations (HMOs) and other managed care systems where providers receive a fixed fee per patient rather than a fee for each service provided.
The implementation of such utilization review processes aims to control costs and prevent unnecessary procedures, aligning with efforts to optimize the efficiency of healthcare delivery seen in regulations like those introduced by the Affordable Care Act (ACA).
The ACA's objective in introducing such reforms was to manage the increase in healthcare costs, examples of which include limiting the amount spent on administrative costs and mandating the switch to electronic medical records (EMRs).