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Myndshft Blog

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December 1, 2022

Why Prior Authorization Software Is the Revenue Stream Multiplier You Want

by Susan Lawson-Dawson | News

As a Software as a Service (SaaS) provider, you’re probably quite familiar with the Rule of 40. As McKinsey & Company explains, the Rule of 40—that a company’s growth rate plus free cash flow rate should equal 40% or more—is a “… favorite of SaaS industry watchers, including boards and management teams, because it neatly distills a company’s operating performance into one number.”  

Unfortunately, McKinsey research also suggests that only 33 percent of SaaS organizations hit that mark and even fewer sustain it long term. Exceeding the 40% mark is even more rare, with only 16% going above and beyond. How can healthcare SaaS providers boost their odds with the Rule of 40? A prior authorization software integration could be the game changer you need. 

Improve retention by delivering automated prior authorization

It’s well documented that high growth companies don’t simply focus on new customer acquisition. They put an equal amount of effort into retaining the customers they already have. Unfortunately, As McKinsey points out, “But neglecting existing customers ends up adding costs in the long run, resulting in more churn, lower cross- and upsell, and more pressure on sales teams just to stay level.” 

We know all too well that healthcare providers desperately want a solution to the frustrating, time-intensive process of identifying and securing prior authorization for the services they deliver. 

In fact, the 2022 MGMA Annual Regulatory Burden Report shows just why your customers need prior authorization software: 

  • 82% of surveyed providers rate prior authorization requirements as”very” or “extremely” burdensome
  • 89% have reallocated or added staff (or both) to work on prior authorizations because volume continues to climb
  • 95% report delays or denials for medically necessary care because of prior authorization requirements

By integrating prior authorization software into your existing SaaS solution, you address a major pain point for customers. They get an in-demand capability—streamlined prior authorizations—directly in their existing workflow. Not only does that improve customer satisfaction and loyalty, but it also creates a new revenue stream that accelerates growth. 

Attract new customers with value-added features

The pandemic heightened demand for efficient processes. Yet according to a survey by America’s Health Insurance Plans (AHIP), 71% of providers do not use EHRs enabled for automated prior authorization. What’s more, they believe it will be too costly or burdensome to add it to their existing solution. 

That means that the SaaS provider that overcomes these hurdles on behalf of its current and future customers has a definite edge over competitors that lack prior authorization software. 

And it doesn’t end there. When you partner with an existing prior authorization solution provider, you can go to market with a lucrative new revenue stream faster. 

Automating prior authorization is a complex undertaking. If it’s not your area of expertise, your development timeline could drag out, leaving your organization vulnerable to faster competitors. 

A technology partner that has already done the heavy lifting solves several challenges:

  • No need to build a payer policy library and rules engine; it’s already built. 
  • No pressure to forge seamless connections between disparate data sources; they’re already made.
  • No need to create documentation and training materials from scratch; you just put your spin on existing materials.

Plus, the right partner already has best practices for onboarding and support locked down. This can help you get customers up and running quickly without having to develop programs from scratch. 

Added up, these benefits mean that your IT staff can stay focused on other priorities while you deliver an enhanced SaaS solution that helps your business grow. 

If you’re aiming to hit the Rule of 40, a prior authorization software integration might be just what the doctor ordered. What’s holding you back? 

Check out our Build versus Buy eBook to learn more.