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 insurance costs are a major factor in an employee benefits package. Here's what to expect from employer-sponsored ...

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 ...

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 ...

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 ...