Medical Case Management and the ROI

Most healthcare providers understand the role of medical case management, but some may still have difficulty quantifying the financial value of these services. A study reported on by the National Library of Medicine on the https://pubmed.ncb.nlm.nih.gov website found that Medicare patients who received patient-centered care transition intervention had significantly lower healthcare utilization in the six…


Increasing Demand for Medical Case Management Services

A recent study released by Coherent Market Insights confirms that medical case management services are in high demand driving the industry’s growth. According to the study, the global medical case management services market size is expected to experience a projected compound annual growth rate (CAGR) of 3.3% by 2027 with revenues topping $6.2M.  There were…


Case Management – Vital to Population Health Management

The term population health management has become commonplace in today’s healthcare vernacular. Still, many people do not fully understand what it is and its importance in improving clinical outcomes. The American Hospital Association (AHA) describes population health management as “a process of improving clinical health outcomes of a defined group of individuals through improved care…


Reducing Hospital Readmission Demands Better Patient Transitions of Care

Despite the heightened focus on reducing preventable hospital readmission for over a decade now, there remains a high number of these incidences. The Centers for Medicare & Medicaid Services (CMS) reported that one in five elderly patients are readmitted within 30 days of discharge. The Center for Health Information and Analysis estimates that hospital readmissions…


Case Management Is Essential in Population Health Management

While major strides have been made in population health management, there is still a long way to go for it to achieve its mission to improve patient health and the broader health of communities. The American Hospital Association (AHA) conducted a population health survey and received responses from over 1,000 U.S. hospitals. What the survey…


Pandemic Prompts Broad Telehealth Use

Even before the pandemic, telehealth was gaining real traction as more and more payers began to recognize the benefits across the healthcare continuum – for patients, providers and payers. Its value proposition in terms of facilitating a quicker response to patient needs, more collaboration between healthcare professionals, and perhaps most significantly, in reducing unnecessary Emergency…


Amalgamated Medical Care Management Granted Full URAC Accreditation for Health Utilization Management and Independent Review Organization

Amalgamated Medical Care Management, a leading national resource for comprehensive, high quality care management services, was recently granted full URAC® accreditation in two service areas – Health Utilization Management and Independent Review Organization. The awards of both accreditations are effective from April 1, 2021 to April 1, 2024. In its letters granting full accreditation to…


Strategies to Help Lower Healthcare Costs

Based on the latest data on the healthcare costs incurred by American businesses, employers are in need of new strategies. According to research conducted by the Kaiser Family Foundation, the average annual premium is now $7,470 for a single employee and $21,342 for family coverage; a 54% increase over the prior ten years. Of these…


Telehealth’s Value Demonstrated during the Pandemic

Even before the pandemic, telehealth was gaining real traction as more and more payers began to recognize the benefits across the healthcare continuum – for patients, providers and payers. Its value proposition in terms of facilitating quicker response to patient needs, more collaboration between healthcare professionals, and perhaps most significantly, in reducing unnecessary Emergency Department…


New CMS OPPS/ASC Rule Demands Effective Utilization Management and Case Management

On December 2nd, 2020, the Centers for Medicare & Medicaid Services (CMS) released its 2021 Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) Final Rule. Among the significant changes are: The elimination of the inpatient only list over three calendar years beginning with the removal of an estimated 300 musculoskeletal-related charges. The list will be…



In the past few weeks there have been numerous restrictions placed on businesses throughout the United States. Many states and localities across the country have enacted temporary restrictions on non-essential business operations, requiring millions of workers to stay home. Amalgamated Life Insurance Company, which is based in New York, is considered an essential business and therefore is not subject to these temporary restrictions.

However, in an effort to protect the health and safety of our employees, their families and communities, we have taken a series of company-wide actions, across all Amalgamated Family of Companies locations, to implement work from home and other flexible arrangements where feasible. Despite these changes, we will continue to provide you and your members with the customer service levels you have come to expect from us prior to the coronavirus outbreak.

We are diligently working with our partners and vendors to utilize our remote capabilities and infrastructure. We are also in constant communication with UPS and the USPS to stay informed of any potential changes in service. For the duration of this state of emergency, Amalgamated Life Insurance Company will comply with any required Notice Obligations by emailing and/or mailing notices to all consumers.

If you have any questions or concerns please reach out to your Amalgamated Family of Companies representative or our customer service center at: 914-367-5000. They are well-prepared to answer your questions and can address your specific needs.