They found that the stringent utilization management criteria used by commercial payers that may delay or deny appropriate treatment for uncontrolled low-density lipoprotein cholesterol (LDL-C) do not ...

Peter L. Salgo, MD: Stepwise, let’s come back. That goes back to what I was asking you. We can all dive in on this. How do you recognize who gets them? In other words, you said “stepwise.” They’ll try ...

We appreciate the thoughtful response of Susan Cantrell and the Academy of Managed Care Pharmacy to our work (August 2021). Our study highlights the burden of drug utilization management on the ...

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 ...

Scott Howell ([email protected]) is the chief strategy officer, US Pharmaceuticals, at Novartis Pharmaceuticals Corporation, in East Hanover, New Jersey. Perry T. Yin is the director of Market Access ...

A 439-page tool box of resource utilization management (UM) model policies, procedures and plans that ‘ work ’ for traditional, streamlined, open access and other cost-effective management strategies.

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 ...

By meeting these standards, ProPeer demonstrates that its utilization management program operates with transparency, clinical rigor, and accountability, providing clients with confidence that reviews ...

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 ...

PLYMOUTH, Minn., Dec. 18, 2018 /PRNewswire/ -- , the leader in image-guided laser interstitial thermotherapy (LITT), is pleased to announce that health insurance provider Anthem, Inc. has established ...

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 ...

DUBLIN, Ireland--(BUSINESS WIRE)--Research and Markets (http://www.researchandmarkets.com/reports/c44767) has announced the addition of Utilization Management and ...