“Utilization Management”

20 result(s)
Cost Management
Utilization Management for a Changing Specialty Landscape
Our enhanced SGM criteria generates greater efficiencies for better cost management, while improving clinically appropriate interventions. More
Briefing
Cost Management
Achieving Cost Control Goals in the "New Normal"
Purpose-built formulary management and network management strategies from CVS Health are designed to help lower plan costs with minimal member disruption. More
Briefing
Care Management
Optimizing Oncology Therapy Selection
Payors can better manage oncology costs by optimizing therapy regimen selection using evidence-based guidelines directly integrated into our proprietary Novologix platform. More
Video
Cost Management
Blunting the Impact of Hyperinflated Drugs
Payors are projected to save on per-member-per-month costs from strategic formulary removals designed to help mitigate the effect of high-cost and hyperinflationary drugs More
Briefing
Specialty
Innovative Cross-Benefit Management
CVS Health uses its integrated model to manage specialty spend across benefits and help positively impact clinical and financial outcomes. More
Briefing
Mother and daughter playing in living room
Care Management
An Integrated Approach for an Evolving Oncology Landscape
Cancer therapy is evolving and new treatments are being developed at an almost breakneck pace. To help better manage care and costs for oncology, CVS Health has developed an... More
Briefing
Senior couple walking on a beach
Specialty
A Foundational Approach to Specialty Cost Management
CVS Health’s three-tier specialty formulary design separates the increasingly more expensive specialty therapies into three distinct copay or coinsurance categories. Paired with... More
Briefing
Female mountain biker, rolling down a hill
Care Management
CVS Caremark Earns NCQA Re-Accreditation for Utilization Management
Earning third-party accreditations is part of our commitment to meeting strict quality standards, and focus on ongoing improvement to helping improve patient safety and improved... More
Briefing
Icon of hammer, gavel and doctor
Public Policy
Legislators Weighing Laws that Could Roll Back PBM Tools
This fall, as state legislatures reconvene, they’ll consider dozens of bills aimed at restricting PBM tools like utilization management that help control costs while ensuring... More
Commentary
Icon of heart rate monitor screen
Cost Management
New Guidelines for PCSK9 Inhibitors
New utilization management criteria ensure appropriate use of PCSK9 inhibitors, which can help lower bad cholesterol levels, but are significantly more expensive first-line... More
Briefing
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