Smart Business Magazine

Integrating utilization and case management for optimal results

Medical management programs are typically comprised of multiple services designed to help control health care costs and ensure optimal health outcomes for employees. “While these sorts of programs can ...

American Specialty Health Joins AHIP Initiative to Transform Pre-Authorization and Utilization Management

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 ...
Becker's Hospital Review

Why utilization management matters

Yet there is positive momentum building against these trends as healthcare organizations look to reinvigorate many value-based care avenues like utilization management. Defined as the group of ...
Fierce Healthcare

Study: Utilization management has ramped up in Part D over past decade

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, ...
Becker's Hospital Review

How automating medical necessity can improve utilization management

The healthcare industry is riddled with opportunities to automate clinical processes. Part of this opportunity stems from the growing prevalence of EHRs over the past decade. As of 2017, 80 percent of ...
The American Journal of Managed Care

Impact of Utilization Management on Physician Autonomy and Shared Decision-Making in Oncology

Panelists discuss how utilization management limits clinical autonomy and advocate for reforms that preserve shared, patient-centered decision-making. Panelists discuss how increasing utilization ...
Business Wire

Sagility Introduces Utilization Management as a Service to Improve Prior Authorization, Mitigate Costs

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 ...
The American Journal of Managed Care

Impact of Utilization Management Policies in Oncology

Panelists discuss how utilization management policies can delay oncology care and call for reforms that better align oversight with clinical evidence. Panelists discuss how utilization management (UM) ...
Business Wire

New Century Health Achieves NCQA Accreditation in Utilization Management

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 ...
Fierce Healthcare

Study: Drug utilization costs health industry $93B a year, with patients bearing most of the cost

Drug utilization management such as prior authorization and stricter formularies cost the healthcare industry $93 billion annually, with patients bearing the largest share of the cost, a new study ...
Forbes

Resource Utilization: Definition, Formulas And Examples

Monique Danao is a highly experienced journalist, editor, and copywriter with an extensive background in B2B SaaS technology. Her work has been published in Forbes Advisor, Decential, Canva, 99Designs ...