Findings of a survey of large employers indicate that utilization management tools are ineffective in controlling health care costs for employees and may lead to barriers to treatment. Employer ...

Navitus, the nation’s first and largest transparent, pass-through pharmacy benefit manager (PBM), today announced the expanded implementation of Banjo Health. Banjo is an advanced automation platform ...

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 ...

UnitedHealth Group UNH turned in mildly stronger fourth-quarter results than expected, highlighting the benefits of its diversified business model even as medical utilization rose. However, those ...

As healthcare costs continue to rise, businesses face increasing pressure to balance comprehensive benefits with financial sustainability. One of the most significant challenges is the escalating cost ...

Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic ...

Thought leaders from MCG Health will present on the topic of assistive AI technology and its transformative impact on utilization management (UM) processes. Additionally, Sharp HealthCare, a valued ...