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 ...

Utilization management involves methods by health care plan administrators to minimize costs while also maintaining the quality of care. The process is intended to prevent wasteful spending but not to ...

The healthcare industry is riddled with opportunities to automate clinical processes. Part of this opportunity stems from the growing prevalence of EHRs over the past decade. As of 2017, 80 percent of ...

Writing effective utilization management goals typically ensures that all resources get expended effectively and efficiently. A committee usually forms to assess and evaluate past practices to set ...

Utilization management policy has many forms, but has become increasingly complex as cancer scientific discovery has blossomed, cancer subtypes have become more numerous, therapeutic opportunities ...

Case management, with its standards of practice of patient advocacy and resource stewardship and its role as a liaison between patients, payors and the healthcare team, is in a unique position to ...

MCLEAN, Va., April 26, 2023 /PRNewswire/ -- The Virginia Department of Medical Assistance Services (DMAS) has awarded Keystone Peer Review Organization, LLC (Kepro), a subsidiary of CNSI, a $113 ...