Category: Utilization Management

From Frustration to Satisfaction: How to Transform the Prior Authorization Experience

In today’s healthcare landscape, managing prior authorizations is a necessary—but painful—step in the delivery of medical and behavioral health treatment. Not only are prior authorization processes often manual and error-prone, but the administrative burden diverts valuable time and resources away from patient care. More concerning, delays in obtaining approval can postpone critical care, causing health… Continue reading From Frustration to Satisfaction: How to Transform the Prior Authorization Experience

Effective Care Coordination Addresses All Determinants of Health to Improve Health Equity

Although health outcomes are influenced not only by medical conditions, but the behavioral and social factors that impact a patient’s well-being, healthcare systems have traditionally focused their efforts primarily on physical and behavioral health. Social determinants of health (SDOH), however, can impact as much as 80 percent of health outcomes and can be a significant cost driver.… Continue reading Effective Care Coordination Addresses All Determinants of Health to Improve Health Equity