Digitization of Prior Authorizations and Utilization Management Driven by Patient First Approach
A conversation between Karen Jagoda of Empowered Patient Podcasts and
Matt Murphy, the executive vice president of network and clinical content at Cohere Heatlth.
Cohere Health is an innovator in utilization management and prior authorization for tests, services, and drugs. By taking a patient-first approach means reviewing cases on behalf of the Cohere health plan clients as well as with an eye to the health outcomes of patients. Matt explains," Utilization management really evolved as an adversarial exercise with health plans pitted against physicians. And if you think about the key areas where it's impacting patients and physicians more broadly, really it's three things. First is delays in care and access. Really there shouldn't be anything coming in between a patient and the care they need as long as it's clinically appropriate. So I'd say that's probably the first issue."