These UM benchmarks maximize savings??

Did you know health plans use their prior authorization list (~2,500 service codes) to manage about 22% of their spend?

Our research report compiles data from 100+ health plans across all segments and lines of business to explore the latest utilization management (UM) benchmarks.

Here’s a preview of what we found:

• Blue Cross Blue Shield plans manage the fewest codes
• Approximately 11% of utilization and 22% of spend is managed?
• Specialties with the most procedure codes managed include surgery, DME, and MSK
• Specialties with the fewest codes include pediatrics, nephrology, and endocrinology

High utilization doesn't always correlate with high spend (or areas of high impact).

The full report will help you kickstart your utilization management strategy.

Key 2023 prior authorization benchmarks: How does your plan stack up?

By Samantha Roushan , SVP, Clinical Transformation at Cohere Health

By Brian Covino , MD, FACC, Chief Medical Officer at Cohere Health

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