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Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
The United States Preventive Services Task Force (USPSTF) is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services". [1]
UnitedHealthcare (UHC) is an insurance and managed care company with four main divisions: UnitedHealthcare Employer and Individual – provides health benefit plans and services for large national employers and individuals. UnitedHealthcare Medicare and Retirement – provides health and well-being services to individuals age 65 and older. [80]
UnitedHealthcare (UHC) is a private insurance company that offers several types of Medicare plans. These include Medicare Part D plans, which provide prescription drug coverage.
UnitedHealth Group shareholders on Wednesday said they requested the company prepare a report on the costs and public health impact related to its "practices that limit or delay access to healthcare."
As of 2017, the largest commercial plans were Aetna, Anthem, Cigna, Health Care Service Corp, UnitedHealthcare, and Centene Corporation. [27] As of 2017, there were 907 health insurance companies in the United States, [28] although the top 10 account for about 53% of revenue and the top 100 account for 95% of revenue. [29]: 70
UnitedHealth posted a better-than-expected profit in the final quarter of 2024, but a nagging rise in medical costs and care utilization surprised Wall Street. Shares of the health care giant slid ...
HealthCare.gov is a health insurance exchange website operated by the United States federal government under the provisions of the Affordable Care Act (ACA), informally referred to as "Obamacare", which currently serves the residents of the U.S. states which have opted not to create their own state exchanges.