America’s Health Insurance Plan launched a prior authorization pilot that intended to achieve a fast track prior authorization process. This new fast PATH( Prior Authorization Technology Highway) action brought a significant changes in the healthcare sector.
- Patients deserve access to the most innocuous, most effective and highest quality care. To accomplish that goal, health insurance providers may use prior authorization – a special methodical approach based on clinical evidence and data that ensured safe and efficient medication of all patients.
- Matt Eyles, President, and CEO of AHIP said, “ when patients do better, we all do better. Patients should receive the right treatment and medications at the right time most effectively and efficiently. That’s why we are committed to reducing additional burden, increasing patient satisfaction, and improving quality and consequences”.
- The fast PATH used automation software from technology companies Availity and Surescripts to digitize prior authorization process. Six health insurer covering more than 50 million Americans cooperated in the pilot: Blue Shield of California, Cambia Health Solution, Cigna, Florida Blue, Humana, and Wellcare.
- The evaluation was carried by RTI Internationals and it was found out that providers used fast PATH tools for 62% of prior authorizations in the last six months after completing the technology. And within that six-month period, the median time between prior authorization submission and a decision from the health plan was thrice faster than before the pilot. RTI concluded, “this finding indicates that although electronic prior authorization processes may lead to faster times to decision, the decision does not change because the rules about prior authorization are the same for both manual and electronic sanction”.