TECH BUYER Apr 2022 - IDC Perspective - Doc # US49001122
IDC Perspective: Prior Authorizations Deep Dive — Feasibility Now Foreseen to Solve This Health Ecosystem Menace
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."
IDC Health Insights: United States Healthcare Payer IT Strategies
CitiusTech Inc., eviCore healthcare, TSIMAGINE INC., Cognizant Technology Solutions Corporation, Availity LLC, Olive AI Inc., Cohere Health Inc., Notable Solutions, Inc., Stanson Health Inc., HealthTrio, LLC, Clover Health LLC, Delaware Corporation, Casenet, LLC, Hindsait, Inc., OpenText Corporation, Exchange EDI, LLC, Prolifics, Inc., Secure Exchange Solutions, Inc., Oracle Corporation, Experian plc, Waystar Inc., ZOLL Medical Corporation, Hyland Software, Inc., Smile CDR Inc., Electronic Referral Manager Inc., CoverMyMeds LLC, Edifecs Inc., Apixio Inc., Surescripts, LLC, Infinx Healthcare, Change Healthcare LLC, Athenahealth, Inc., TransUnion LLC, Myndshft Technologies, Inc., Medecision, Inc., ZS Associates Inc., Lyniate, Agadia Systems, Inc., MdToolbox, Imagine Software Inc., XSOLIS, Inc., Azalea Health, Optum, Inc., Encore Technology Group, PracticeSuite Inc., NantHealth Inc., Allscripts Healthcare LLC, PriorAuthNow, IBM, Milliman, Inc., InterSystems Corporation
Analytic applications, Cognitive/artificial intelligence, Integration and process automation middleware, Technology buyer
Health delivery strategies, Healthcare strategies, Value-based health
List of Figures
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