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 ...

Now implemented across employer and health plan lines of business, including Medicare and Medicaid, these capabilities enable Navitus to deliver more efficient prior authorization, appeals and ...

BERWYN, Pa.--(BUSINESS WIRE)--AscellaHealth, a national specialty pharmacy benefit manager (SPBM™) serving commercial, Medicare and Medicaid segments, announces a new specialty medical benefit ...

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 ...

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 ...

The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

With workplace benefits playing an influential role in supporting employee well-being, closing this education and utilization gap is essential. "Employers and employees agree that workplace benefits ...

Panelists at an Academy of Managed Care Pharmacy (AMCP) Nexus 2022 session discussed enhanced utilization management strategies to manage the rising cost of specialty drugs, while providing members ...

Scott Howell ([email protected]) is the chief strategy officer, US Pharmaceuticals, at Novartis Pharmaceuticals Corporation, in East Hanover, New Jersey. Perry T. Yin is the director of Market Access ...

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 ...