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, ...

Rebates aren’t disappearing, but PSG's 2026 survey suggests payers increasingly favor lower net costs, biosimilars and price ...

A medical professional explains the many facets of the prior authorizations process for drugs in women’s health. Ryan Haumschild, PharmD, MBA, MS: Prior authorizations are something that we’re used to ...

A peer-reviewed analysis published in the January 2026 issue of Health Affairs offers a sobering assessment of where healthcare AI is headed. Stanford University authors reviewed 21 AI tools currently ...

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 ...

Considering the recent article by Scott Howell and colleagues (August 2021), I want to clarify how drug utilization management tools are used to help millions of patients access the medications they ...

8 Managed Care Contract Questions Regarding Utilization and Management Naya Kehayes, managing principal and CEO of Eveia Health Consulting and Management, recommends hospitals and other providers ask ...

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 ...

On this episode of Managed Care Cast, we speak with the author of a study published in the November 2024 issue of The American Journal of Managed Care® to explore the link between utilization ...

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 ...

California Governor Newsom signed Senate Bill 1120 into law, which is known as the Physicians Make Decisions Act. At a high level, the Act aims to safeguard patient access to treatments by mandating a ...

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 ...