In 1988, December received the designation of HIV/AIDS Awareness Month in the U.S., coinciding with the United Nations’ World AIDS Day on December 1st. Since the peak of the HIV / AIDS epidemic in the 1980s, the CDC says annual infections have declined by more than two-thirds. While the decline represents a significant positive trend, roughly 1.2 million Americans still live with HIV. More unfortunately, new infection rates highlight ongoing health inequities. For example, the CDC notes that: African Americans (12% of US population) account for 40% of new HIV infections Hispanic/Latinos (18% of US population) account for 29% of… Read entire article here
As healthcare continues its value-based care (VBC) journey, the need to optimize inefficient administrative processes remains acute. Prior authorization software offers a clear path, helping providers cut through the time-consuming maze of manual efforts with a streamlined, automated process. How does leveraging a unified platform for medical and pharmacy prior authorizations support value-based care? Pandemic a catalyst for VBC momentum Unlike traditional fee-for-service (FFS) models, value-based care focuses on patient outcomes and rewards healthcare providers for efficiency and effectiveness. And, based on new data recently reported by RevCycle Intelligence, adoption of VBC models is climbing. The article notes, “Over half… Read entire article here
What is the biggest bottleneck in healthcare delivery? Over the years, prior authorization has earned its reputation as a barrier to care. Despite being intended as a measure to ensure the most effective and cost-efficient treatment, the typical manual prior authorization process often has the opposite effect. A recent Mayo Clinic article, for example, looks at the impact of the prior authorization process on gastroenterologists and patients with inflammatory bowel disease (IBD). Research findings suggest that savings evaporate in the face of care delays that contribute to declining health and subsequently more utilization. One of the study’s co-authors, Dr. Francis… Read entire article here
Dealing with prior authorizations compares to navigating a labyrinth—complex, frustrating, and time-consuming. Created to ensure the optimal use of healthcare resources and minimize unnecessary expenses, these authorizations come in two flavors: medical and pharma. What differentiates the two, and why should you care? As the regulatory landscape around interoperability, prior authorizations, and pharmacy benefit managers (PBMs) continues to evolve, integrated prior authorization software offers a robust solution now and into the future. What distinguishes medical prior auth from pharma prior auth? Medical prior authorizations pertain to the pre-approval necessary for various healthcare services like surgeries, diagnostic tests, or medical equipment.… Read entire article here
