Last month, Cohere Health was named a winner of the KLAS 2024 Points of Light award for collaborating with our health plan and provider partners.

For a third consecutive year, Cohere was honored for driving a successful partnership with a health plan and a provider organization to reduce friction and administrative burden, and improve patients outcomes by bundling related prior authorization requests. Our case study was featured in KLAS Research’s Points of Light Report, Celebrating Payer & Provider Partnerships That Enhance Healthcare Outcomes.

KLAS’ annual K2 Collaborative Points of Light awards celebrate successful partnerships—or “points of light”—that are reducing cost and inefficiencies and improving the patient, provider, and payer experience.

Our case study: Episodic authorizations

Through Cohere’s intelligent prior authorization platform, providers at OrthoTennessee can bundle multiple related prior authorizations into a single transaction, based on a sequence of services identified as clinically optimal for a patient’s care episode. 

Referred to as “episodic authorizations,” this unique capability–paired with automated outbound communications from the health plan to inform care teams and their patients about the pre-approved authorizations–reduces duplicative administrative work and delays in care, further streamlining the prior authorization process.

Dive deeper

We’re honored to receive another Points of Light Award from KLAS, who are leaders in the field of healthcare IT research and validation. What’s more, we’re extremely proud that KLAS recognized our innovative work around episodic authorizations. 

Having worked in lockstep with our partners on the initial pilot, I saw firsthand how episodic authorizations are uniquely positioned to reduce administrative burden by enabling providers to use pre-approved authorizations (instead of submitting duplicate requests)–and how they drive better patient outcomes by facilitating swift access and adherence to evidence-based, high-value care paths.

Some of the notable outcomes realized through this collaboration:

  • 35% reduction in separate prior authorization requests for surgery, pre-op physical therapy (PT), and post-op PT
  • 6 – 8 minutes saved by providers submitting PT authorization requests
  • 11-unit reduction in post-op PT visits, on average

Cohere’s intelligent prior authorization platform processes over 5.6 million requests annually, positively impacting more than 15 million health plan members and 457,000 healthcare providers nationwide. Currently, Cohere’s solutions are utilized by several major health plan clients nationwide, including Humana, Geisinger, and Medical Mutual.

Read the full case study and learn more about KLAS’ K2 Collaborative here.

Published On: July 3rd, 2024Categories: Blog

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About the Author: Traci Granston M.D.

Dr. Granston serves as the Vice President and Medical Director of Clinical Strategy for Musculoskeletal at Cohere Health. She is an orthopedic surgeon based in Washington who specializes in hand surgery and practices at Proliance Orthopedic Surgeons. She attended medical school at Vanderbilt University. She completed her residency in Orthopedic Surgery at Case Western Reserve University School of Medicine and a Hand and Microvascular Fellowship at University of Washington School of Medicine. Dr. Granston earned her executive M.B.A. from the University of Washington Foster School of Business. She is currently a fellow of AAOS, and also serves on a cabinet at Vanderbilt University School of Medicine dedicated to raising capital for students who may struggle with affording tuition.