Surescripts announced that several national, regional and local PBMs and health plans representing virtually all U.S. patients are replacing their manual prior authorization process with Surescripts Electronic Prior Authorization solution. Over the past 18 months, several national, regional and local PBMs and health plans representing virtually all U.S. patients have signed on, increasing the number of insured lives covered by Surescripts Electronic Prior Authorization by nearly 20%.
Impact of Prior Authorization
Prior authorization has been top of mind as of late stemming from CMS’ proposed rule to update the electronic prior authorization requirements for Medicare Part D plans. However, there is no industry standard that requires the implementation of this technology, despite the burden of the manual process. The process is ultimately meant to provide medication safety and cost benefits to patients and health plans but 80% of providers don’t have access to information about prior authorization requirements when they begin the prescribing process.
Enter electronic prior authorization tools. By removing the administrative burden from manual prior authorizations in real time at the point of care, this tool is helping to ensure that patients take home the right medication the first time and adhere to their treatment. It’s also having a significant impact on provider satisfaction, saving time and unnecessary headaches.
In 2018, adoption of Surescripts Electronic Prior Authorization increased by 128%. The top five specialties using Surescripts Electronic Prior Authorization are family practice, internal medicine, psychiatry, pediatrics, and neurology.
“Together with our health plan and PBM partners, the Surescripts Network Alliance™ is having a significant impact on patient-provider satisfaction and medication adherence,” said Tom Skelton, Chief Executive Officer of Surescripts. “By removing the administrative burden from prior authorizations in real time at the point of care, we’re helping ensure that patients take home the right medication the first time, and adhere to their treatment.”