AJMC September 5, 2024
Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management.
Like many others, I was drawn to be a doctor because I wanted to help people. When I first started working in managed care, I told myself that I would leave if I ever felt I was not serving patients and upholding the same values that guided my time practicing pediatric and emergency medicine.
It’s been nearly 20 years, and I am still here.
Health plans have a responsibility to prioritize quality care and drive the best and most cost-effective health solution for each person, and utilization management helps us do so. I also know that industry-standard utilization management practices,...
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