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 ...

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 ...

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 ...

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, ...

BREA, Calif.--(BUSINESS WIRE)--NCH Management Systems, Inc., D/B/A New Century Health (NCH), a national leader in specialty care management, today announced it has been accredited in Utilization ...

Bhavesh Shah, PharmD, and Robert Groves, MD, discuss the priorities payers should be taking into account when managing psoriasis treatment. Ryan Haumschild, PharmD, MS, MBA: Hello and welcome to this ...

PALM BEACH GARDENS, Fla.--(BUSINESS WIRE)--Dane Street, a national leader in Independent Medical Exams and Reviews, announced today that it has achieved Accreditation in Utilization Management from ...

Advances in biomarker-driven and individualized approaches in neurology and psychiatry will require new frameworks for value ...

Navitus, the nation’s first and largest transparent, pass-through pharmacy benefit manager (PBM), today announced the expanded implementation of Banjo Health. Banjo is an advanced automation platform ...

DALLAS, June 5, 2025 /PRNewswire/ -- MCG Health, part of the Hearst Health network and an industry leader in evidence-based guidance and technology, announces its participation in the 2025 CMSA Annual ...

California Governor Newsom signed Senate Bill 1120 into law, which is known as the Physicians Make Decisions Act. At a high level, the Act aims to safeguard patient access to treatments by mandating a ...