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 ...

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 ...

GenHealth.ai and Guidehealth achieved up to a 60% reduction in Utilization Management workload using GenHealth’s AI-native platform, leading to $1.2M in annual savings. The system automates clinical ...

Peoria, Ill.-based OSF HealthCare will use an AI-based and machine learning platform to streamline its utilization management services and improve workflows. The new platform, dubbed CORTEX, will help ...

Findings of a survey of large employers indicate that utilization management tools are ineffective in controlling health care costs for employees and may lead to barriers to treatment. Employer ...

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, ...

New research findings from EXL shows how healthcare leaders can leverage AI to transform utilization management.

Drug utilization management such as prior authorization and stricter formularies cost the healthcare industry $93 billion annually, with patients bearing the largest share of the cost, a new study ...

FRISCO, Texas--(BUSINESS WIRE)--Magellan Healthcare Inc., the behavioral healthcare segment of Magellan Health, Inc., today announced that it has earned full URAC accreditation for Health Utilization ...

Benefit plan sponsors know they can rely on their brokers for many insurance products and voluntary benefits. Brokers, however, also have an opportunity to be even more of a resource to their clients ...