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 ...
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 ...
HealthLeaders Media

The Exec: How to Succeed in Utilization Management

Jill O'Brien, Morton Hospital's new CMO, says the essence of utilization management is providing the right care for the right patient in the right setting at the right time. The new CMO of Morton ...

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 ...
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 ...
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, ...

Employers Using Direct Primary Care Models Experience Reduced Healthcare Utilization Costs

When employees have reliable access to primary care, behavior changes” — Chad Carrone SLIDELL, LA, UNITED STATES, January 2, 2026 /EINPresswire.com/ — Employers across multiple industries are ...
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 ...
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 ...
Health Affairs

The Role Of Utilization Management: The Authors Reply

We appreciate the thoughtful response of Susan Cantrell and the Academy of Managed Care Pharmacy to our work (August 2021). Our study highlights the burden of drug utilization management on the ...
The American Journal of Managed Care

Association of Care Management Intensity With Healthcare Utilization in an All-Condition Care Management Program

Higher intensity of care management in an all-condition program addressing care coordination and care barriers was associated with increased healthcare utilization among Medicaid and Medicare patients ...