Utilization management is described as the implementation of guidelines that reduce unnecessary use of medical resources (Kongstvedt, 2007, p.190). There are several methods used to ensure that costs are kept to a minimum without compromising patient care. The use of utilization management (UM) is producing financial benefits that are leading managed care organizations (MCOs) and facilities to invest more in UM programs. Health maintenance organizations' (HMOs) use of the primary care physician (PCP) as a "gatekeeper" initially had MCOs see the restrictions as a negative approach to patient choices. However, some necessary measures have been initiated that reduce unnecessary usage by imposing some restrictions. UM applications and tools include: Demand management (DM), which refers to various approaches by a health plan to ensure that the most effective and necessary care plan is provided to the patient. DM can be provided by health plans in the form of nurse advice lines. This tool has always been available with most HMO plans. It is staffed by nurses available to answer member questions 24 hours a day, seven days a week. This service is now emerging with PPOs, Medicare, and Medicaid, among others. It provides benefits to the member by reducing trips to the emergency room due to conditions that could easily be treated with a non-urgent method (Kongstvedt, 2007, p.192). Nurses play a vital role in UM, a study conducted by Jencks, Williams, and Coleman (2009) showed that Medicare spent approximately $17.4 billion on beneficiaries who were readmitted within 30 days of discharge. A further study conducted by Bobay, Yakusheva, and Weiss (2011) suggested that the increase in nurse staffing before the middle of the article ......tKongstvedt, P. R. (2007). Essentials of managed healthcare. (5th ed.). Sudbury, MA: Jones and Bartlett Publishers. Radzwill, M. A. (2002). Integrating case and disease management: why and how?. Disease Management and Health Outcomes, 10(5), 277-289. Retrieved from EBSCOhostWickizer, T.M., & Lessler, D. (2002). Usage management: problems, effects and future prospects. Annual Review of Public Health, 23(1), 233. Retrieved from EBSCOhostBobay, K.L., Yakusheva, O., & Weiss, M.E. (2011). Results and cost analysis of the impact of unit-level nurse staffing on postdischarge utilization. Nursing Economic$, 29(2), 69-87. Retrieved from EBSCOhostJencks, SF, Williams, MV, & Coleman, EA (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine, 360(14), 1418-1428. doi:10.1056/NEJMsa0803563