What You Should Know:
Free Market Health, a Pittsburgh-based healthcare technology company transforming the specialty pharmacy ecosystem with a care-driven marketplace platform, today announced its $13.5M in Series A financing led by Alta Partners and with participation from existing investors Highmark Ventures and 653 Investment Partners.
- The capital will enable the company’s team of specialty pharmacy industry experts to scale beyond the hundreds of millions of dollars in specialty
Read More
Prior Authorization
GuideWell Becomes First U.S. Payer to Automate Prior Authorizations
What You Should Know:
- GuideWell, one of the 10 largest health insurance providers in the U.S., became the first U.S. payer to automate prior authorization approvals through AI-powered clinical reviews from Olive, resulting in faster care for patients — up to 10 days faster — and greater provider satisfaction.
- After launching a pilot with Olive in Florida, GuideWell saw its time to decision reduced by 10 days when immediate responses were available, decreased unnecessary prior
Read More
Prior Authorizations: 3 Ways to Reduce Administrative Burden & Burnout
Medicare’s annual enrollment period has started, and you know what that means: a slew of commercials suddenly appearing on television for Medicare Advantage plans.
The advertising appears to be working. Enrollment in Medicare Advantage has more than doubled over the past decade to more than 26 million people this year. The private health plans, which are an alternative to traditional Medicare, account for 42% of the total Medicare population.
The growth of Medicare Advantage, though, has
Read More
Cohere Health, Humana Expand Partnership to Transform Prior Authorization Process
What You Should Know:
- Cohere Health announced that Humana Inc. is embarking on a nationwide expansion of Cohere's digital prior authorization platform for musculoskeletal (MSK) services, based on the success of its initial implementation.
- After rolling out the platform across 12 states in January 2021, Humana has made significant progress toward achieving its vision to reimagine and modernize processes for prior authorization by reducing approval times, increasing provider
Read More
Banjo Health Lands $5M for AI-Driven Prior Authorization Platform
What You Should Know:
- Banjo Health, a Washington-based provider of AI-driven prior authorization ("PA") solutions, announced today it has raised in excess of $5 million in Series A financing led by Epsilon Health Investors, with participation from Spark Growth Ventures and Tau Ventures. Epsilon Health Investors Co-Founder and General Partner, Gregory Epstein, will be joining Banjo Health's Board of Directors.
- Banjo Health is focused on bringing transparency and automation to PA through
Read More
Cohere Health Raises $36M to Automate Prior Authorization Between Payers & Providers
What You Should Know:
- Boston-based health IT company Cohere Health has closed a $36 million Series B funding round led by Polaris Partners, with additional participation from new investors Longitude Capital and Deerfield Management, as well as existing investors Flare Capital Partners and Define Ventures. The round comes less than a year after the company launched, and only 3 months after a Series A extension.
- Cohere Health’s AI-based, fully
Read More
Healthcare Can Save $16.3B Automating Administrative Transactions, Report Finds
What You Should Know:
- Each year, the US healthcare industry spends $39 billion on 9 administrative transactions, according to a new report from CAQH.
- The 2020 CAQH Index also uncovered that by automating these transactions, the industry could save $16.3 billion annually--a 42% cost reduction.
CAQH, released the eighth annual report measuring the progress made by healthcare payers and providers in automating administrative transactions. The 2020 CAQH Index found that, of
Read More
How Automation is Key to the Future of Healthcare Operations
As the saying goes, necessity is the mother of invention. A similar correlation is seen in the quest to leverage innovation and out-of-the-box thinking to address key problems facing the healthcare industry. The ongoing COVID-19 pandemic has brought the immense pressure the U.S. healthcare system is under into sharp focus. Recent dynamics are compounded by the industry’s efforts to adopt newer ways of working and digitizing patient records, while implementing automation throughout their business
Read More
20 COVID-19 Predictions and Trends for 2021 – Executive Roundup
Dr. Justin Graham, Chief Medical Officer, GYANT
The rapid development of a COVID-19 vaccine is a monumental achievement, but it does nothing to address our extremely fragmented healthcare system. In 2021, policymakers must create and extend incentives to providers to work together to keep patients healthy rather than maximize profit. The pandemic has devastated the traditional fee-for-service budgets of many healthcare systems, and it isn't clear they will ever be able to catch up without
Read More
M&A: Olive Acquires AI Prior Authorization Company Verata Health
What You Should Know:
- On the heels of $225.5 million dollars in funding and a
$1.5B valuation this week, Olive today announced its acquisition of Verata
Health to create a combined AI prior authorization solution for providers and
payers under the Olive name.
- Prior authorization is a $31 billion dollar issue in
healthcare, and one of the top reasons patient care is delayed. Olive is now
able to reduce write-offs by over 40% and cut turnaround times for prior
authorizations by up to
Read More
