As healthcare moves toward the full embrace of value-based care models, utilization management is increasingly leveraged as a means to not only manage costs but to ensure quality and manage risk as well.

Both payer and provider organizations are leveraging UM as a key strategy of various population health initiatives. With these programs, UM is used to maintain the highest quality of care while reducing or eliminating care that is inefficient, wasteful or unnecessary. As UM takes on new meaning and increased importance under value-based care, though, healthcare organizations need an approach to deal with various challenges that arise.

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