The AI arms race utilization management intensifies payer-provider conflicts, raising risks for hospitals and health systems nationwide.

ACMA National Conference features leaders and professionals affiliated with case management and transitions of care taking place April 20-23 in Orlando, FloridaFRANKLIN, Tenn., April 15, 2026 (GLOBE ...

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, ...

As artificial intelligence tools become more integrated and routine in care delivery, new enforcements could focus on ...

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 ...

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 ...

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

MCG Health, part of the Hearst Health network and the industry's source of truth for trusted clinical guidance, announces that its Director ...

Smarter Technologies, the smarter revenue cycle platform, today announced a major platform advancement: SmarterUtilization ™ , a clinical AI solution designed to transform inpatient 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 ...

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 ...

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 ...