Utilization management began as a way for health care organizations and professionals to evaluate the effectiveness and efficiency of the services they provide to patients. The approach has grown and ...

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 ...

Assessing differences in utilization management between managing an IV product in terms of medical benefit vs. self-administered oral product in terms of pharmacy benefit. Transcript: Neil B. Minkoff, ...

Writing effective utilization management goals typically ensures that all resources get expended effectively and efficiently. A committee usually forms to assess and evaluate past practices to set ...

Medical management programs are typically comprised of multiple services designed to help control health care costs and ensure optimal health outcomes for employees. “While these sorts of programs can ...

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 ...

For years, utilization management (UM) was quietly delegated away for scale, speed, and supposed efficiency. But today, health plans are hitting the breaking point. Prior authorizations, a core ...

In this episode of the Becker’s Healthcare Podcast, Lukas Voss is joined by Chad Kersting, Business Development Director, and Dr. Eric Gratias, National Physician Executive of Medical Benefit Services ...

NEW YORK--(BUSINESS WIRE)--Today, VirtualHealth announced the release of a completely redesigned Utilization Management (UM) module within its cloud-based care management solution HELIOS®. The newly ...

BREA, Calif.--(BUSINESS WIRE)--NCH Management Systems, Inc., D/B/A New Century Health (NCH), a national leader in specialty care management, today announced it has been accredited in Utilization ...