Ep 3. The Games Insurers Play: Utilization Management and Prior Authorization

In this week's episode of the VHV podcast we'll take a comprehensive look at utilization management (UM) and prior authorization (PA). Utilization management is the healthcare industry term for the various techniques health insurance companies employ to pay for care on their terms, according to their guidelines. Many times, their utilization management approach is in line with what physicians recommend. However, many times it is not. And when it's not, patients suffer delays in their care and physicians and their staff end up mired in extra work to make sure their patients get the care they have determined is best.

What is Value Health Voices?

We discuss the most impactful health policy and healthcare finances developments shaping the US Healthcare system now and in the future. We also discuss personal development for physician executives. Co-hosts Dr Anthony Paravati and Dr Amar Rewari.