TECH BUYER Apr 2022 - IDC Perspective - Doc # US49001122

IDC Perspective: Prior Authorizations Deep Dive — Feasibility Now Foreseen to Solve This Health Ecosystem Menace


Jeff Rivkin

This IDC Perspective outlines the context, pain, and initiatives undertaken by payers, governments, organizations, providers, and vendors to address the prior authorization annoyance in the health ecosystem.

"Although prior authorization has been historically troublesome for healthcare stakeholders across the board, there is a light at the end of the tunnel," says Jeff Rivkin, research director, Payer IT Strategies at IDC Health Insights. "Data-driven collective decision making is key to solving prior authorization. All major players in the health ecosystem have issued a 'Consensus Statement on improving the Prior Authorization Process,' value-based contracts are driving collaboration, dozens of vendors are attacking the problem, and technological solutions such as FHIR, RPA, AI, ML, and CDS are at the forefront of healthcare IT's contribution to fixing prior authorization. A collaborative approach is the only way to tackle the issue. We now have the means and motivations to address this controlling transaction that exemplifies the pain caused in the fragmented healthcare/payer environment."



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