AI and the State of Utilization Management: Lessons for Health Plans

Many current utilization management processes lack the transparency, speed and interoperability needed to meet current requirements — and the stakes for health plans are rising as CMS-0057 deadlines loom.

This podcast breaks down new national research on UM practices across payer organizations, offering a clear-eyed view of what’s working, what’s not and where change is most needed.

Leaders will also explore how AI-assisted technologies could help health plans get ahead of future interoperability challenges, including those tied to CMS-0057.

Key insights include:

• Where UM processes are breaking down across health plans and care settings
• How AI-assisted tools could reduce delays and improve alignment now and in the future
• Real-world takeaways to improve speed, transparency and readiness ahead of CMS-0057