SPRINGFIELD — Gov. J.B. Pritzker celebrated a partial legislative victory Thursday night when the House passed his initiative to end some practices health insurance companies use to control the amount ...

Findings of a survey of large employers indicate that utilization management tools are ineffective in controlling health care costs for employees and may lead to barriers to treatment. Employer ...

Intelligent prior authorization enables faster access to care and higher quality outcomes for members while enhancing provider experience and improving operational efficiencies BOSTON and CLEVELAND ...

The American Society of Clinical Oncology (ASCO) has raised concerns that utilization management strategies, especially for high-cost prescription drugs, could reduce patient access. Health plans ...

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 ...

Case management, with its standards of practice of patient advocacy and resource stewardship and its role as a liaison between patients, payors and the healthcare team, is in a unique position to ...

NEW YORK--(BUSINESS WIRE)--Today, VirtualHealth announced the release of a completely redesigned Utilization Management (UM) module within its cloud-based care management solution HELIOS®. The newly ...

Health insurance represents one of the largest recurring expenses for most households, yet many policyholders unknowingly waste significant money through preventable mistakes and missed opportunities.

Les Masterson is a deputy editor and insurance analyst at Forbes Advisor. He has been a journalist, reporter, editor and content creator for more than 25 years. He has covered insurance for a decade, ...

Health insurance helps to reduce medical costs, making health care more affordable and thus more accessible. Having health insurance also facilitates access to care, resulting in lower death rates and ...