Risk Sharing Requires Health Plans to Hone Utilization Management Process
Healthcare organizations’ success under risk sharing and value-based care relies on a well-oiled UM program.
Addressing Social Determinants of Health Can Lead to Better Health Outcomes
Research shows that social determinants of health (SDoH)—such as housing, transportation, access to healthy food and more—are linked to patient outcomes. Managed care organizations are partnering with community and social support providers to address SDoH to deliver better health outcomes.
“Utilization Management” is all about saving health plans money. Or is it?
Until recently, Utilization Management was all about how health plans determine preauthorization. But that definition is fast becoming outdated.
Utilization management: What’s it got to do with population health?
What does Utilization Management have to do with Population Health? The answer: everything.
