For years, utilization management (UM) was quietly delegated away for scale, speed, and supposed efficiency. But today, health plans are hitting the breaking point. Prior authorizations, a core ...

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 ...

Two topics dominate almost every conversation about value-based care (VBC): risk adjustment and quality. They are, without question, foundational. Risk adjustment sets the financial baseline for each ...

Endowment funds invest donations to generate income without reducing principal, aiding nonprofits. Fund structures vary by use rules; withdrawals often limited to sustain funds long-term. Vanderbilt ...

In this episode of the Becker’s Healthcare Podcast, Lukas Voss is joined by Chad Kersting, Business Development Director, and Dr. Eric Gratias, National Physician Executive of Medical Benefit Services ...

The fact that a machine is in your fleet does not mean that you can assume it is working to produce completed construction and contribute to the bottom line. Many things can go wrong, and many things ...

Forbes contributors publish independent expert analyses and insights. I write about business model strategy and execution across healthcare. Feb 24, 2025, 04:52pm EST Photo of a stethoscope on an ...

First-line therapies analysis in advanced/metastatic urothelial carcinoma: Prognostic insights with propensity score analysis and RNA-seq. Enfortumab vedotin plus pembrolizumab in metastatic ...

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TYSONS, Va.--(BUSINESS WIRE)--Maximus, a leading employer and provider of government services worldwide, today announced it has again earned URAC full accreditation for Health Utilization Management ...