The use of medical case management continues to grow in all settings. Offsite medical case management, in particular, is experiencing significant growth. According to data released by ReportLinker and reported by Yahoo Finance on August 1, 2023, the offsite medical case management market size is projected to grow from $4.97 billion in 2023 to $5.94…

Healthcare in America is in a very dynamic period.  We have already witnessed the introduction of value-based healthcare, population health management and telehealth. New specialty drugs are being developed and approved at a rapid pace. The industry has continued to evolve to embrace new technologies, new models of care and advanced technologies, all of which…

The Assistant Secretary for Planning and Evaluation (ASPE) is the principal advisor to the Secretary of the U.S. Department of Health and Human Services on policy development, which is primarily responsible for major activities in policy coordination, legislation development, strategic planning, policy research, evaluation, and economic analysis. The organization recently released an Issue Brief titled…

McKinsey & Company recently published its “What to expect in US healthcare in 2023 and beyond,” and it is a good news, bad news forecast. Cited are the challenges the healthcare industry is facing, notably continuing inflation and persistent labor shortages. McKinsey, however, is projecting that healthcare profit pools will grow at a 4 percent…

If you’ve been to a hospital recently, you or a loved one has experienced firsthand the nation’s nursing shortage. The situation has become so dire that nurses have taken to the picket lines to protest what they consider to be unsafe nurse-to-patient ratios. A study by the National Council of State Boards of Nursing reported…

For health plan sponsors, care management programs can benefit both employees and their employers. Not only can they help employees gain better control over their health and well-being, but they also enable plan sponsors to contain healthcare costs. For these reasons, it is important to understand care management’s value proposition. Care Management’s Value to Plan…

Healthcare in America is undergoing a major transformation, and in part, further prompted by the pandemic. We’re seeing many more consumers and healthcare providers use telehealth, as well as other technologies such as mobile apps to improve patient health literacy, treatment compliance and outcomes. Medical case management also continues to evolve as today’s latest trends…

Like many business processes, utilization management (UM) is being advanced by Artificial Intelligence (AI). The application of AI technology, as well as Machine Learning (ML), predictive analytics and real-time data, is driving a significant reduction in the time required to perform many administrative UM functions. Understanding how UM has evolved through technology and how today’s…

America’s 65 and older population is growing. According to the U.S. Census Bureau, there were 54 million seniors aged 65 and older living in America in 2020.  By 2035, it is projected that there will be 78 million American adults over age 65 and by 2040, this group is projected to grow to 78 million….

Across the nation, healthcare providers are experiencing unprecedented nursing shortages. Even before the pandemic, nursing shortages were evident with the COVID-19 pandemic only made the situation worse. There are several reasons for the shortages, but the prevailing one is the nurse-to-patient ratios which nurses are reeling against. Many are even striking to make a greater…