The American Journal of Managed Care

Utilization Management Through Medical and Pharmacy Benefit

Assessing differences in utilization management between managing an IV product in terms of medical benefit vs. self-administered oral product in terms of pharmacy benefit. Transcript: Neil B. Minkoff, ...
The American Journal of Managed Care

Utilization Management in Women’s Health

A medical professional explains the many facets of the prior authorizations process for drugs in women’s health. Ryan Haumschild, PharmD, MBA, MS: Prior authorizations are something that we’re used to ...
Business Wire

Availity to Acquire Utilization Management Solution and Business Unit from Olive

JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity, one of the nation’s largest real-time health information networks, announced a definitive agreement to acquire the utilization management solution and ...
Becker's Hospital Review

8 Managed Care Contract Questions Regarding Utilization and Management

8 Managed Care Contract Questions Regarding Utilization and Management Naya Kehayes, managing principal and CEO of Eveia Health Consulting and Management, recommends hospitals and other providers ask ...
Fierce Healthcare

Study: Utilization management has ramped up in Part D over past decade

Utilization management in Medicare Part D has become more restrictive over the last decade, even when compared to Medicare Advantage prescription drug plans, according to a new study. The study, ...
Business Wire

Sagility Introduces Utilization Management as a Service to Improve Prior Authorization, Mitigate Costs

DENVER--(BUSINESS WIRE)--Sagility, LLC, a technology-enabled healthcare business process management (BPM) company, has announced the launch of its Utilization Management as a Service (UMaaS) offering ...
HealthLeaders Media

The Exec: How to Succeed in Utilization Management

Jill O'Brien, Morton Hospital's new CMO, says the essence of utilization management is providing the right care for the right patient in the right setting at the right time. The new CMO of Morton ...
Becker's Hospital Review

Breaking the cycle: How leveraging love, process redesign enhanced utilization management and elevated patient care

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 ...
Fierce Healthcare

Study: Drug utilization costs health industry $93B a year, with patients bearing most of the 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 ...
Forbes

Utilization Management Is Broken–Fixing It Requires A New Business Model

Forbes contributors publish independent expert analyses and insights. I write about business model strategy and execution across healthcare. Feb 24, 2025, 04:52pm EST Photo of a stethoscope on an ...