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Points of Light 2023 Case Study 19
Improving Patient Access to Medication by Automating Prior Authorization Process
Author
Boyd Stewart
Author
Aurene Wilford
The lack of an efficient, standardized process for submitting prior authorization requests for medications was creating administrative burden for the provider and payer organizations in this case study and in some cases delaying patient access to prescribed medications. The collaborators worked with their technology partner to automate data sharing, increase provider visibility into medication coverage, and standardize the submission process for prior authorization. The changes have reduced the workload for the payer and provider organizations and enabled patients to more quickly access their medications.
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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 Best Practices Can Other Organizations Replicate?
- What's Next?—Vision for the Future
Writer
Elizabeth Pew
Designer
Jess Wallace-Simpson
Project Manager
Joel Sanchez
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.