Cohere Health, an emerging high growth digital health company, announced today a formal collaboration with the American Academy of Orthopaedic Surgeons (AAOS) to embed AAOS clinical recommendations into the care pathway guidelines included in the CohereNext® Platform. As part of the collaboration, AAOS’ American Joint Replacement Registry (AJRR) participants, if opted in, will have the ability to demonstrate their clinical performance in a way that Cohere can reduce their prior authorization burden. The arrangement marks the first of its kind for a prior authorization vendor and the AAOS.

“As an experienced, orthopedic surgeon and member of AAOS, I am thrilled to be able to integrate AAOS’ clinical guidelines into our offerings, specifically our CohereNext platform,” said Brian Covino, MD, FAAOS, Chief Medical Officer of Cohere Health. “This is the largest implementation of evidence-based recommendations and guidelines to manage usage of musculoskeletal procedures. Based on the latest, clinically supported recommendations and guidelines, orthopedic surgeons will be able to easily plan and pre-authorize all of the steps in the procedures and recovery that get patients back to the health they deserve.”

Cohere Health’s dynamic digital technology and approach to applying clinical guidelines is unique in how it aligns prior authorization around longitudinal, evidence-based models for diagnosis and treatment. At the onset, the agreement between Cohere Health and AAOS will affect the practices of up to 10,000 unique surgeons across registries in 12 states. In recent years, AAOS has been lobbying for physician-led alternative payment models, bundled payments, and easy prior authorizations for an entire patient’s care plan.

“Being able to provide our registry participants the ability to lessen their data burden is a big priority for all of the AAOS registries,” said Bryan D. Springer, MD, FAAOS, chair of the AJRR Steering Committee. “Our relationship with Cohere Health makes it possible for those who opt into this program through AJRR to benefit from preauthorization for their patients’ hip and knee replacements.”

The costs of a siloed and broken healthcare system are well documented. The Journal of the American Medical Association (JAMA) released information compiled from more than 70 estimates of over 50 peer-reviewed publications and government reports. Combined computations yield that total annual cost of waste includes: failure of care coordination, $27 to $72 billion; overtreatment or low value care, $76 to $101 billion; and administrative burden, $266 billion.

“Given the scalability of Cohere Health and our technology capabilities, we are able to reduce business and data silos and improve prior authorization processes between payers and providers that alleviate burdens and administrative costs and drive better patient outcomes and quality,” said Siva Namasivayam, CEO of Cohere Health. “The AAOS is the preeminent medical society representing orthopaedic surgeons in the United States, and through this relationship, we will be able to incorporate their clinical guidelines so surgeons know they’ve easily and thoroughly diagnosed, planned and authorized a complete and effective course of care.”