National healthcare spending reached $5.3 trillion in 2024 as Americans continued to ravenously consume healthcare coming out of the coronavirus pandemic, according to a new report from CMS actuaries.

Health insurers and health care provider organizations are increasingly using artificial intelligence (AI) tools in prior authorization and claims processes. AI offers many potential benefits, but its ...

For years, utilization management (UM) was quietly delegated away for scale, speed, and supposed efficiency. But today, health plans are hitting the breaking point. Prior authorizations, a core ...

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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 ...

BEIJING, Aug 5 (Reuters) - China's renewable power potential in far-flung provinces is increasingly going unused, official statistics showed on Monday, as the country rushes to build more ...

A score was developed to measure patient risk from payer utilization management policies and its relationship to real-world US commercial payer utilization management policies. Objectives: To (1) ...

States with Medicaid expansions spend more per enrollee overall than nonexpansion states, and nearly half of expansion states’ enrollees have a chronic condition, a May 28 KFF Health News report found ...

Pharmacoeconomic analysis of perioperative chemo-immunotherapy in resectable stage III non small cell lung cancer (NSCLC): Survival time cost-efficacy based on NADIM 2 trial. PF scores and estimated ...

The offshore rig market recovery appears to have taken a pause, with demand tapering off and marketed utilization hitting the lowest levels recorded since recovery began in 2021. A variety of factors ...