National Survey Shows Insurer Utilization Management Interferes with Cancer Treatment Decisions

COA survey of independent community oncology practices shows insurer requirements delay treatment, override clinical ...

Abarca Forward 2026 Marks Five Years of Industry Momentum with a Bold Agenda to Reimagine Prior Authorization and Utilization Management

Abarca Health hosted the fifth edition of Abarca Forward 2026, bringing together senior healthcare leaders from across the ...
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 ...
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 ...
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, ...
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 ...
The American Journal of Managed Care

Impact of Utilization Management on Physician Autonomy and Shared Decision-Making in Oncology

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

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 ...
Morningstar

GenHealth.ai and Guidehealth Achieve Up to 60% Reduction in Utilization Management Workload Through AI-Native Platform

GenHealth's AI-native UM platform integrates seamlessly with existing medical guidelines, administrative policies, and provider portals to automate data intake, escalation logic, and decision ...
Health Affairs

The Role Of Utilization Management: The Authors Reply

We appreciate the thoughtful response of Susan Cantrell and the Academy of Managed Care Pharmacy to our work (August 2021). Our study highlights the burden of drug utilization management on the ...