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Points of Light 2024 Case Study 10
Reducing Administrative Burden & Improving Patient Outcomes through Bundled Prior Authorization Approvals
Author
Boyd Stewart
Author
Aurene Wilford
A lengthy prior authorization process was delaying needed care for OrthoTennessee patients who had received knee surgery. To resolve this issue, they partnered with Humana and Cohere to bundle prior authorizations together into a single transaction. This reduced the administrative burden on the provider and payer organizations and increased the timeliness of patient care.
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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
Natalie Hopkins
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.