Utilization management (UM) is a painstakingly manual process that adds administrative burden, increases healthcare waste and complicates payer-provider dynamics — yet does not necessarily improve ...

The definition of UM has changed. Some of the results remain stubbornly the same (and unclear). While utilization management clearly has a role in healthcare, the jury is still out on its ability to ...

New technologies that use predictive analytics in conjunction with evidence-based criteria are transforming utilization management and improving clinical and financial outcomes. Incorporating ...

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 ...

Medical management programs are typically comprised of multiple services designed to help control health care costs and ensure optimal health outcomes for employees. “While these sorts of programs can ...

Panelists at an Academy of Managed Care Pharmacy (AMCP) Nexus 2022 session discussed enhanced utilization management strategies to manage the rising cost of specialty drugs, while providing members ...

"UM absolutely has its place," says Dr. Cathy Moffitt, Senior Vice President and Aetna Chief Medical Officer at CVS Health. Now, Part 3 explores how UM can be a vital part of the path to value-based ...

Russell Rotondo, MD, FACC, medical director of clinical strategy and innovation for cardiology at Cohere Health, discusses the myriad positive ways utilization management programs can have an impact ...

TAMPA, FL / ACCESS Newswire / June 1, 2025 / Amid escalating regulatory requirements, increasing cost pressures, and rising consumer expectations, Black Book Research today announced the top-rated ...