Oliver Wyman September 12, 2024
Insurers wanting to adopt a best-in-class approach to utilization management need to be nimble and creative.
Editor’s note: This is part one of a series looking at ways insurers can transform utilization management. Upcoming articles will examine utilization management policies and processes.
They are two of the most dreaded words in healthcare: prior authorization. Physicians loathe the process, claiming it can negatively impact patient outcomes and results in undue administrative burden. Lawmakers are pressing regulators to take a closer look at the process as well. While there are legitimate concerns around its varied implementation, prior authorization, as well as the broader set of utilization management tools, can play a meaningful role in controlling high pharmaceutical spending, limiting unnecessary procedures, and...
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