How can health systems deliver the right care, at the right cost, in the right setting, without overwhelming delivery and reimbursement systems with administrative burden? The shift from volume to ...

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 ...

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 ...

AnMed, a nonprofit health system serving residents of upstate South Carolina and Georgia, will leverage XSOLIS’ artificial intelligence (AI) and machine learning (ML) tools to drive greater clinical ...

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 ...

Utilization management offers opportunities to promote patient safety, and there need to be systematic ways to identify and manage patient-safety issues throughout the utilization management process, ...

For too long, utilization management (UM) has been the most painful source of abrasion between health plans and healthcare providers. Care decisions are too often made by third-party vendors with ...

Oncology utilization management often frustrates patients and payers, but collaboration and artificial intelligence can streamline processes and improve care quality, according to Vishnukamal Golla, ...

Florida-based Halifax Health deployed an artificial intelligence-based solution to streamline utilization management workflows across its three hospitals this week. The health system will leverage a ...

Utilization management refers to the process of making decisions that can increase efficiency in delivery of quality health care services. It covers issues such as clinical case appeals, discharge ...

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 ...

A recent opinion from the Commonwealth Court of Pennsylvania has changed the rules for Utilization Review and thrown open the doors to a new class of litigants. In Keystone Rx, LLC v. AmeriHealth (Fee ...