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Tag: unified medical and pharmacy prior authorization platform

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November 27, 2023

HIV & AIDS: How Prior Authorization Software Creates Smoother Care Pathways

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

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

November 15, 2023

The Intersection of Prior Authorization and Value-Based Care: Leveraging Software for Success

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

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

October 27, 2023

Unlocking Savings and Efficiency: The Financial Advantages of Automating Prior Authorization in Pharma Benefits

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

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