Summary of Utilization Management & Prior Authorization Transformation for Medicaid Plans
Prior authorization (PA) continues to make headlines as health plans make slow progress in improving the process, and federal/state governments continue to issue new regulations mandating greater PA automation, transparency, and turnaround times. Medicaid plans that invest in digitizing PA can not only speed the process and stay ahead of regulatory requirements, but can also lay the groundwork for faster and better care outcomes for beneficiaries.
Your plan can improve outcomes by incorporating patient-specific SDOH, filling provider network gaps, and enabling value-based care success for your provider partners, all with the same innovative approach to digitizing PA. Learn more about how Medicaid plans can benefit from our approach.
Attendee takeaways:
- Coming prior authorization regulations and what they mean for health plan operations
- Innovative approaches to fully digitizing prior authorization
- How a digitized prior authorization process can be leveraged to incorporate SDOH and provider network analysis to speed and improve outcomes
- How these approaches can drive more successful value-based care arrangements
Featured Cohere Health speakers:
- Brian Covino, MD, FAAOS, Chief Medical Officer
- Gina Kim, Chief Product Officer
- Mary Krebs, MD, FAAFP, Associate Medical Director, Primary Care
- Aimée Bailey, RN, MHA, Senior Director, Clinical Programs
About Cohere Health
Cohere is a clinical intelligence company that is transforming utilization management (UM) by aligning physicians and health plans on evidence-based care paths for the patient’s entire care journey. By integrating these care paths into the prior authorization submission process, Cohere’s digital UM collaboration platform reduces denial rates and medical expenses while improving patient outcomes. The company is a winner of the TripleTree iAward and has been named to both Fierce Healthcare’s Fierce 15 and CB Insights’ Digital Health 150 lists. Cohere’s investors include Flare Capital Partners, Define Ventures, Deerfield, Polaris Partners, and Longitude Capital.
