Utilization management in Medicare Part D has become more restrictive over the last decade, even when compared to Medicare Advantage prescription drug plans, according to a new study. The study, ...

A medical professional explains the many facets of the prior authorizations process for drugs in women’s health. Ryan Haumschild, PharmD, MBA, MS: Prior authorizations are something that we’re used 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 ...

The AI arms race utilization management intensifies payer-provider conflicts, raising risks for hospitals and health systems nationwide.

TYSONS, Va.--(BUSINESS WIRE)--Maximus, a leading employer and provider of government services worldwide, today announced it has again earned URAC full accreditation for Health Utilization Management ...

8 Managed Care Contract Questions Regarding Utilization and Management Naya Kehayes, managing principal and CEO of Eveia Health Consulting and Management, recommends hospitals and other providers ask ...

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 ...

Jill O'Brien, Morton Hospital's new CMO, says the essence of utilization management is providing the right care for the right patient in the right setting at the right time. The new CMO of Morton ...

Commercial payers are increasingly using laboratory benefit managers to manage laboratory test utilization. LBMs represent a relatively newer area of utilization management, although they are similar ...

Considering the recent article by Scott Howell and colleagues (August 2021), I want to clarify how drug utilization management tools are used to help millions of patients access the medications they ...

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 ...

Navitus, the nation’s first and largest transparent, pass-through pharmacy benefit manager (PBM), today announced the expanded implementation of Banjo Health. Banjo is an advanced automation platform ...