For years, utilization management (UM) was quietly delegated away for scale, speed, and supposed efficiency. But today, health plans are hitting the breaking point. Prior authorizations, a core ...

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 ...

TYSONS, Va.--(BUSINESS WIRE)--Maximus, a leading employer and provider of government services worldwide, today announced it has again earned URAC full accreditation for Health Utilization Management ...

DENVER--(BUSINESS WIRE)--Sagility, LLC, a technology-enabled healthcare business process management (BPM) company, has announced the launch of its Utilization Management as a Service (UMaaS) offering ...

For years, delegating utilization management (UM) functions to third-party vendors was seen as a practical response to rising medical costs, regulatory complexity, and distributed networks. Vendors ...