{"id":9676,"date":"2025-11-18T14:31:00","date_gmt":"2025-11-18T14:31:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=9676"},"modified":"2025-11-18T14:31:00","modified_gmt":"2025-11-18T14:31:00","slug":"why-health-plans-are-reclaiming-utilization-management-and-what-it-takes-to-do-it-right","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=9676","title":{"rendered":"Why Health Plans Are Reclaiming Utilization Management, and What It Takes to Do It Right"},"content":{"rendered":"<p><a href=\"https:\/\/medcitynews.com\/2025\/11\/why-health-plans-are-reclaiming-utilization-management-and-what-it-takes-to-do-it-right\/\"><\/a><\/p>\n<p>CMS and AHIP are raising the floor, but forward-thinking plans are aiming higher. They\u2019re designing utilization management systems that are clinically sound, operationally efficient, and aligned with enterprise goals.<\/p>\n<p>The post <a href=\"https:\/\/medcitynews.com\/2025\/11\/why-health-plans-are-reclaiming-utilization-management-and-what-it-takes-to-do-it-right\/\">Why Health Plans Are Reclaiming Utilization Management, and What It Takes to Do It Right<\/a> appeared first on <a href=\"https:\/\/medcitynews.com\/\">MedCity News<\/a>.<\/p>","protected":false},"excerpt":{"rendered":"<p>CMS and AHIP are raising the floor, but forward-thinking plans are aiming higher. They\u2019re designing utilization management systems that are clinically sound, operationally efficient, and aligned with enterprise goals. The post Why Health Plans Are Reclaiming Utilization Management, and What It Takes to Do It Right appeared first on MedCity News.<\/p>\n","protected":false},"author":0,"featured_media":9677,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-9676","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/9676"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9676"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/9676\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/9677"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9676"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9676"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9676"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}