The healthcare industry is riddled with opportunities to automate clinical processes. Part of this opportunity stems from the growing prevalence of EHRs over the past decade. As of 2017, 80 percent of ...

Yet there is positive momentum building against these trends as healthcare organizations look to reinvigorate many value-based care avenues like utilization management. Defined as the group of ...

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 ...

Key opinion leaders share their perspectives on utilization management strategies in treatment of women’s health. Neil Minkoff, MD: We talked a little about managing oral contraceptives. Maria, you ...

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 ...

Medical management programs are typically comprised of multiple services designed to help control health care costs and ensure optimal health outcomes for employees. “While these sorts of programs can ...

A longitudinal case-control design was used to evaluate the effects of the patient-centered medical home model on medical costs and utilization among high-risk patients. Commercial health maintenance ...

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 ...

UnitedHealth Group UNH turned in solid third-quarter results, largely absorbing challenges with medical utilization and the Change Healthcare network outage. However, management slightly reduced the ...