Altruista Health has announced today that Priority Health has gone live with the GuidingCare® Authorization Portal, a new tool that will save Michigan providers countless hours in seeking preauthorization on behalf of Priority Health members. Providers can now stop faxing and phoning in requests and get nearly immediate responses through this new electronic portal, developed in a unique collaboration between Altruista, Priority Health, and its parent organization, Spectrum Health System.
- An integrated health platform: Priority Health and Spectrum Health are an integrated health system serving nearly 1 million health plan members and representing 97 percent of Michigan’s primary care practices and 96 percent of the state’s hospitals. This collaborative three-way project emerged during the implementation of Altruista’s GuidingCare® care management technology platform at Priority Health last year.
- Barriers of Manual process: Preauthorizations for treatment support value-based care by aligning care with world-leading, up-to-date clinical guidelines. But industry research shows that most providers turn first to the fax machine, phone, or U.S. mail to obtain preauthorization.1 These manual processes slow the care process significantly and create friction between health plans and providers, with the potential to create member uncertainty and anxiety.
- PreAuthorization issues: “We spoke with a group of providers to hear their preferences and needs when it comes to going through the preauthorization process,” said Ann Donnelly, Vice President of Care and Utilization Management at Priority Health. “Our providers are on the frontlines of delivering high-quality care to their patients and our members, so implementing the Portal is going to help solve some of the preauthorization issues and delays when it comes to them receiving that care.”
- Perfect collaboration: Altruista saw an opportunity to custom-build a portal that would serve Priority Health and Spectrum Health’s needs, but also one it could replicate for other customers. The process was complex since it involved building a new tool in the midst of the implementation of its care management platform. Altruista’s product, engineering, and implementation teams worked in tandem, as well as coordinating with Priority Health’s teams.
- Optimizing treatment: “The value-add for the system is that Authorization Portal integrates with the world’s leading clinical guidelines to assure an optimal treatment path is being provided,” said Mike McKitterick, Executive Vice President of Clinical Services at Altruista. “Preauthorization requests are instantly bounced off the latest clinical guidance to validate appropriateness.”