Healthcare organizations’ success under risk sharing and value-based care relies on a well-oiled UM program.
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.
Until recently, Utilization Management was all about how health plans determine preauthorization. But that definition is fast becoming outdated.
What does Utilization Management have to do with Population Health? The answer: everything.