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 ...

A discussion on utilization management strategies for optimizing the treatment for patients with heart failure. Jaime Murillo, MD: The beauty and challenge at the same time in heart failure is that we ...

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 ...

Mayor Michelle Wu’s administration and Boston’s public employee unions are in a high-stakes standoff over how to handle ...

Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic ...

Your benefits package looked excellent. Between the health insurance, the flexible scheduling, and your employees assistance program (EAP), you were confident that your staff would be able to manage ...

Population health management is a perennial challenge for benefits leaders. If money were no object, a company could offer all manner of perks that might contribute to better health. But with ...

The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...