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 ...

As healthcare costs continue to rise, businesses face increasing pressure to balance comprehensive benefits with financial sustainability. One of the most significant challenges is the escalating cost ...

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 ...

Population health management is a perennial challenge for benefits leaders. If money were no object, a company could offer all manner of perks that might contribute to better health. But with ...

UnitedHealth Group UNH turned in mildly stronger fourth-quarter results than expected, highlighting the benefits of its diversified business model even as medical utilization rose. However, those ...

Navitus, the nation’s first and largest transparent, pass-through pharmacy benefit manager (PBM), today announced the expanded implementation of Banjo Health. Banjo is an advanced automation platform ...

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 ...

In this episode of the Becker’s Healthcare Podcast, Lukas Voss is joined by Chad Kersting, Business Development Director, and Dr. Eric Gratias, National Physician Executive of Medical Benefit Services ...

The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

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 ...