Efforts to reform utilization management policies must prioritize clinical value, improve transparency, ensure alignment with ...

Expediting a Utilization Review decision is dependent on hospitals sharing the proper health information with plans. This ...

States with Medicaid expansions spend more per enrollee overall than nonexpansion states, and nearly half of expansion states’ enrollees have a chronic condition, a May 28 KFF Health News report found ...

Concurrent review ... ongoing healthcare services to ensure the patient is receiving the right level of care, at the right time, in the right setting. Considering its importance to utilization ...

DALLAS, June 5, 2025 /PRNewswire/ -- MCG Health ... for utilization management. Sharp integrated this new technology with evidence-based guidelines from MCG to facilitate appropriate care ...

One in seven people in the US speak ... examined health care spending differences by English proficiency status, 24, 25 and no recent studies have compared the health care utilization patterns ...

Unlike several cultural-war bills spawned from the Trump administration, there is significant support for healthcare billing ...

Unsustainable finances are impacting hospitals, clinics and doctors’ offices alike, despite Vermont’s high health care costs ...

You probably don't need to be told that health care costs are going up. You likely see it on your bank statement or pay stub. But if you like data with your financial pain, according to the ...