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

Rebates aren’t disappearing, but PSG's 2026 survey suggests payers increasingly favor lower net costs, biosimilars and price ...

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 ...

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 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, ...

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 ...

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 ...

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 ...

Bhavesh Shah, PharmD, and Robert Groves, MD, discuss the priorities payers should be taking into account when managing psoriasis treatment. Ryan Haumschild, PharmD, MS, MBA: Hello and welcome to this ...

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 ...

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