Fatalities due to heart disease are on the rise, but there is hope! Studies show that over 70% of all cardiovascular disease cases and deaths are attributable to modifiable risk factors. 

What are modifiable risk factors? Simply put, it means that the trajectory of heart disease can be altered drastically through provider and patient behavior changes. We can start by reducing care variation and aligning treatment with evidence-based medicine and clinical practice guidelines. Intelligent prior authorization is one way to achieve this change.

An intelligent prior authorization (PA) approach does what legacy PA cannot. It makes the most of “moments of influence”—opportunities where we can provide recommendations tailored to patients’ unique needs and aligned with the most up-to-date clinical best practices.

Here’s how PA transformation can impact cardiovascular care:

  • Automatically triggered care paths provide longitudinal context to individual service requests
  • Auto-decisioning based on clinical evidence and innovative technology reduces care variation
  • AI-driven nudges make real-time recommendations to drive optimal care choices without denying requests

Does it sound as interesting to you as it does to me? Read more about how innovation is reducing waste while improving outcomes in this white paper, Streamlining Cardiovascular Care.

Featured Content


We explore how health plans can harness intelligent utilization management technology to ensure a timely diagnosis, the delivery of gold-standard cardiac care, and the best outcomes for each patient.

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