The future of utilization management is here
Health plans should act now to address 3 shifts in utilization management
Utilization management (UM) is being redefined. From new regulatory mandates to rising expectations for clinical precision and provider collaboration, health plans are rethinking how UM delivers value.
Our latest executive brief examines three major shifts shaping UM today — and what health plans can do to lead.
Inside the brief:
- A shift to automation is the new baseline for UM efficiency.
- The Centers for Medicare & Medicaid Services’ Interoperability and Prior Authorization Final Rule (CMS-0057-F) is raising the bar for transparency, care coordination, and data access.
- Why clinical expertise is now central to smarter, faster UM decisions.
- The future of UM and how the right strategic partner can help navigate what’s next.
See what’s changing — and how your organization can lead.