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 ...
Now implemented across employer and health plan lines of business, including Medicare and Medicaid, these capabilities enable Navitus to deliver more efficient prior authorization, appeals and ...
As healthcare costs continue to rise, businesses face increasing pressure to balance comprehensive benefits with financial sustainability. One of the most significant challenges is the escalating cost ...
BERWYN, Pa.--(BUSINESS WIRE)--AscellaHealth, a national specialty pharmacy benefit manager (SPBM™) serving commercial, Medicare and Medicaid segments, announces a new specialty medical benefit ...
UnitedHealth Group UNH turned in mildly stronger fourth-quarter results than expected, highlighting the benefits of its diversified business model even as medical utilization rose. However, those ...
Scott Howell ([email protected]) is the chief strategy officer, US Pharmaceuticals, at Novartis Pharmaceuticals Corporation, in East Hanover, New Jersey. Perry T. Yin is the director of Market Access ...
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 ...
Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic ...
SAN DIEGO, Dec. 16, 2025 /PRNewswire/ -- American Specialty Health's (ASH's) ongoing commitment to industry best practices on utilization management (UM) has led to joining more than 60 full-service ...
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