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AI And Standards Aren’t Enough: Fixing Prior Authorization Will Require Something Else Entirely

Published in: Forbes


At Premier, one of the country’s largest group purchasing organizations representing more than 4,400 hospitals and health systems, addressing the burden of prior authorization is a priority. The company in 2018 acquired Stanson Health, a technology company providing clinical decision support tools that are integrated into providers’ EHR systems. As Stanson Health’s Ryan Nellis explains, “Prior authorization is clinical decision support. It’s a set of rules, based on evidence. It’s just frustrating because it happens after the fact, and makes everybody [providers and patients] wait until it’s resolved.”

Nellis touts the company’s novel approach, in which it ingests prior authorization rules from partnered health plans and applies those rules within a provider’s EHR workflow, as a key reason the company has seen its technology deployed to more than 1,000 hospitals.

Read full article here.

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