Case management, with its standards of practice of patient advocacy and resource stewardship and its role as a liaison between patients, payors and the healthcare team, is in a unique position to ...

How can health systems deliver the right care, at the right cost, in the right setting, without overwhelming delivery and reimbursement systems with administrative burden? The shift from volume to ...

New solution extends clinical and financial intelligence to utilization management, helping health systems accelerate decisions, reduce administrative burden, and improve revenue predictability.

While utilization management in general is a pain point for everyone, it’s a necessary evil in the United States, where we spend 18% of our gross domestic product on healthcare, explained Debra Patt, ...

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 ...

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 ...

DENVER--(BUSINESS WIRE)--Sagility, LLC, a technology-enabled healthcare business process management (BPM) company, has announced the launch of its Utilization Management as a Service (UMaaS) offering ...

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 ...

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 ...