"Rx for trimming health-care costs" (Financial Tactics, August) omitted several important elements that are available to contain and trim health-care costs. Some of these are alternative funding, coordination of benefits and subrogation, and utilization review.

It has been estimated that utilization review, including concurrent hospital review, ambulatory surgery, retrospective hospital review to modify practice patterns, preadmission testing, and consultation, can result in as much as an 8.8% decrease in health-care costs. Utilization review such as that provided by this company has demonstrated a cost/benefit ratio from 1:4 to 1:9.

One cannot address the issue of health-care cost management without seriously evaluating utilization review and the other elements enumerated.