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Points of Light 2022 Case Study 7
Quadruple Aim Is the Goal for Provider and Payer Organizations’ Separate Use of AI-Enabled Prior Authorization Solution
Author
Boyd Stewart
Author
Lois Krotz
The technology in this case study is used by Essentia Health and GuideWell to automate the prior authorization process and thus reduce manual processes and delays in care. This case study is unique in that the highlighted healthcare and payer organizations pursued their prior authorization automation independently of each other. Their perspectives demonstrate how the technology is able to reduce friction for both the provider and payer markets without direct collaboration or contracting.
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Key Findings:
- Executive Summary
- The Collaborators
- Points of Friction—Challenges to Be Solved
- Action Plan—How the Collaborators Worked Together to Reduce Friction
- Points of Light—Outcomes Achieved through Collaboration
- Lessons Learned
- What's Next?
Writer
Elizabeth Pew
Designer
Madison Moniz
Project Manager
Mary Bentley
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.