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, ...

Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...

By meeting these standards, ProPeer demonstrates that its utilization management program operates with transparency, clinical rigor, and accountability, providing clients with confidence that reviews ...

Cape Town, Western Cape / Syndication Cloud / February 19, 2026 / BestProjectKits Project management tools have evolved ...

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

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 ...

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 ...

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 ...

Unfortunately, this book can't be printed from the OpenBook. If you need to print pages from this book, we recommend downloading it as a PDF. Visit NAP.edu/10766 to get more information about this ...

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 ...

Unfortunately, this book can't be printed from the OpenBook. If you need to print pages from this book, we recommend downloading it as a PDF. Visit NAP.edu/10766 to get more information about this ...