What You Should Know:
– Health insurer Humana has expanded its partnership with Cohere Health to streamline the prior authorization process for cardiovascular care and surgical specialties. Both these care pathways are clinically complex, involving multiple exchanges between primary care physicians and specialists, which can contribute to costly and unnecessary variations in care.
– For surgical services, Humana staff will use the Cohere Unify™ platform to accelerate patient access to care by facilitating the review and approval of surgical procedure prior authorization requests. By ensuring requests are reviewed expeditiously, the platform helps providers and patients avoid the complications that can arise from delayed care. By automating and bundling the prior authorization processes for cardiovascular and surgical services, Humana expects to reduce care variation, drive higher quality care, and minimize administrative burden.
– The expansion of the partnership comes after Cohere Health and Humana teamed up to bundle and accelerate prior authorization processes for musculoskeletal care. That work spans across the country and has yielded reduced administrative burden, faster turnaround times, and improved quality of care.