NEWTON, Mass.--(BUSINESS WIRE)--The healthcare world is changing. And the new release of InterQual ® is all about helping you manage appropriate care through these changes. Available now, InterQual ...

Panelists discuss how utilization management limits clinical autonomy and advocate for reforms that preserve shared, patient-centered decision-making. Panelists discuss how increasing utilization ...

LONDON--(BUSINESS WIRE)--Quantzig, a pure-play analytics solutions provider, has announced the completion of their latest big data analytics engagement on the health insurance marketplace. A leading ...

Value-based care requires collaboration between payers and providers to ensure the patient receives the most appropriate care in the most appropriate setting. However, the current utilization ...

Following a brief discussion on utilization management, experts discuss the current paradigm of patient access to therapy. Neil Minkoff, MD: Dr Stephens, could you also weigh in on how utilization ...

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 ...

“Many employers and their health plan members assume that a utilization management program’s only goal is to approve or deny medical procedures and save costs for the health plan. In reality, ...

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 ...

The medical leader details how one payer practices utilization management. For our series The Exec, Dr. Cathy Moffitt — SVP and Aetna Chief Medical Officer at CVS Health — talked 21 st century ...

Clinical practice in the United States is marked by significant variation, leading in some cases to suboptimal quality of care and poor health outcomes. Despite the proliferation of clinical practice ...

California Governor Newsom signed Senate Bill 1120 into law, which is known as the Physicians Make Decisions Act. At a high level, the Act aims to safeguard patient access to treatments by mandating a ...