While there has been significant attention given to eliminating systemic biases and addressing social determinants of health in the national conversation, the ability to access healthcare can also be hindered by the utilization management (UM) processes. In particular, prior authorization, which necessitates approval from a payer before a member can receive medical treatment. Although it may seem logical to assume that this barrier affects all members equally, regardless of their race or socioeconomic status, the reality is that prior authorization disproportionately impacts predominantly impoverished, rural and minority communities. Automated prior authorization can help overcome disparities. Problem: Providers in underserved communities… Read entire article here
The American Cancer Society expects newly diagnosed cancer cases in 2023 to exceed 1.9 million—and that figure doesn’t even factor in skin cancers not subject to reporting. The good news: The cancer death rates have been on the decline. Between 1991 through 2020, the rate dropped by 33%, thanks in large part to early detection and treatment advances. What hasn’t declined is the volume of prior authorizations required. If anything, volume is higher than ever as payers try to control costs through utilization management. As a result, says Oncology Insights, 70% of oncologists report needing full-time staff to manage prior… Read entire article here
Staffing challenges and clinician well-being have emerged as critical concerns in the healthcare industry. While “mindfulness” is a popular coping mechanism for daily stressors, some problems are too big. Recently, Politico interviewed American Medical Association President Jack Resneck about a number of challenges in healthcare. Responding to a question about solving burnout he said, “You can’t yoga your way out of severe burnout because you’re spending hours a day doing prior authorization.” And therein lies the reason that a growing number of healthcare providers tackle this administrative burden with prior authorization software. Let’s delve into how this software offers much-needed… Read entire article here
Delivering a good patient experience is more important than ever. As the healthcare provider landscape continues to evolve, traditional providers increasingly go up against consumer-friendly retail giants who know what it takes to meet (and exceed) consumer expectations. FierceHealthcare reports that utilization of retail clinics has increased 200% over the past five years, outperforming urgent care centers, primary care practices and hospital ERs. Are you prepared to be compared? Cue the prior authorization software. When automation combines with what we call Collective Healthcare Intelligence™, it creates a symphony of efficiency that will have a positive impact on patient experiences. How? … Read entire article here
