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 ...

Outcomes-based contracts are gaining traction among health plans, as new Avalere research finds 59 percent of payers have used the payment model. Avalere researchers administered a survey to 50 payers ...

ALBANY — A contract dispute between two prominent Capital Region health organizations could disrupt care for more than 100,000 patients and highlights growing challenges of an industry in need of ...