Yet there is positive momentum building against these trends as healthcare organizations look to reinvigorate many value-based care avenues like utilization management. Defined as the group of ...

Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...

Utilization management involves methods by health care plan administrators to minimize costs while also maintaining the quality of care. The process is intended to prevent wasteful spending but not to ...

Panelists discuss how utilization management limits clinical autonomy and advocate for reforms that preserve shared, patient-centered decision-making. Panelists discuss how increasing utilization ...

Imagine an altogether different kind of utilization management that both payers and providers appreciate, where approvals are made at the point of decision, not after the fact. Utilization management ...

Following a brief discussion on utilization management, experts discuss the current paradigm of patient access to therapy. Neil Minkoff, MD: Dr Stephens, could you also weigh in on how utilization ...

NEWTON, Mass.--(BUSINESS WIRE)--The healthcare world is changing. And the new release of InterQual ® is all about helping you manage appropriate care through these changes. Available now, InterQual ...

Enter utilization management. My experience with UM is that most of us do hold our access to prescribed treatment as an inalienable right. Inserting a utilization manager between a consumer and ...

LONDON--(BUSINESS WIRE)--Quantzig, a pure-play analytics solutions provider, has announced the completion of their latest big data analytics engagement on the health insurance marketplace. A leading ...

Utilization management policy has many forms, but has become increasingly complex as cancer scientific discovery has blossomed, cancer subtypes have become more numerous, therapeutic opportunities ...

California Governor Newsom signed Senate Bill 1120 into law, which is known as the Physicians Make Decisions Act. At a high level, the Act aims to safeguard patient access to treatments by mandating a ...