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 ...

Value-based care requires collaboration between payers and providers to ensure the patient receives the most appropriate care in the most appropriate setting. However, the current utilization ...

“Many employers and their health plan members assume that a utilization management program’s only goal is to approve or deny medical procedures and save costs for the health plan. In reality, ...

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 ...

SAN DIEGO, Dec. 16, 2025 /PRNewswire/ -- American Specialty Health's (ASH's) ongoing commitment to industry best practices on utilization management (UM) has led to joining more than 60 full-service ...

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 ...

GREENSBORO, N.C., March 20, 2018 /PRNewswire/ -- No one wants to switch utilization management systems. That was especially true for Greensboro-based Triad HealthCare Network (THN). The accountable ...

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 ...

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 ...

This survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them. Objective: This study was designed to assess physician ...