The AI arms race utilization management intensifies payer-provider conflicts, raising risks for hospitals and health systems nationwide.

TYSONS, Va.--(BUSINESS WIRE)--Maximus, a leading employer and provider of government services worldwide, today announced it has again earned URAC full accreditation for Health Utilization Management ...

FRISCO, Texas--(BUSINESS WIRE)--Magellan Healthcare Inc., the behavioral healthcare segment of Magellan Health, Inc., today announced that it has earned full URAC accreditation for Health Utilization ...

Health care providers have employed utilization management to reduce the number of preventable hospital readmissions in the past. But today, plan sponsors — including businesses, unions, trust funds, ...

Peoria, Ill.-based OSF HealthCare will use an AI-based and machine learning platform to streamline its utilization management services and improve workflows. The new platform, dubbed CORTEX, will help ...

Key opinion leaders share their perspectives on utilization management strategies in treatment of women’s health. Neil Minkoff, MD: We talked a little about managing oral contraceptives. Maria, you ...

GenHealth’s AI-native UM platform integrates seamlessly with existing medical guidelines, administrative policies, and provider portals to automate data intake, escalation logic, and decision ...

MedeAnalytics, an industry pioneer in AI-powered enterprise healthcare intelligence, analytics, and data management, and Basys.ai, an innovation leader in agentic AI for healthcare, today announced a ...

Amyotrophic lateral sclerosis (ALS) is a fatally progressive degenerative disease, with many patients succumbing to the condition within 3 to 5 years after diagnosis. It is a rare, orphan disease with ...

GenHealth.ai and Guidehealth achieved up to a 60% reduction in Utilization Management workload using GenHealth’s AI-native platform, leading to $1.2M in annual savings. The system automates clinical ...