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 ...

NEW YORK--(BUSINESS WIRE)--VirtualHealth, provider of HELIOS, the leading SaaS care management platform, today announced the launch of a fully integrated, ground-breaking utilization management ...

Utilization management policy has many forms, but has become increasingly complex as cancer scientific discovery has blossomed, cancer subtypes have become more numerous, therapeutic opportunities ...

How can health systems deliver the right care, at the right cost, in the right setting, without overwhelming delivery and reimbursement systems with administrative ...

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 ...

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 ...

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

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 ...

New York-based healthcare review organization NYCHSRO/MedReview, Inc. has been granted URAC accreditation for its Independent Review (IRO) and Health Utilization ...

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 ...