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Utilization management, more specifically prior authorization, has made headlines as the industry grapples with what is an essential but frequently loathed healthcare process. Prior authorization is an essential tool for health plans to manage clinical quality, patient safety, and better value of care. But the process as it exists today represents a host of challenges for health plans, providers, and patients, frequently putting them at odds with one another rather than aligning them around the common goal of better health.

We outline what the next generation of utilization management looks like and how taking a transformative approach can not only ensure care quality, optimal outcomes, and patient safety but also better experiences for providers and patients while driving medical costs savings that exceed the traditional denial-based approach.

Cohere Health
Sep 15, 2022
Sep 6, 2022
White Paper

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