Streamlining Prior Auth Processes in a Public Academic Health Center
Manual prior authorizations cause a significant headache for the healthcare industry. They significantly impact staff productivity, organizational efficiency, and revenue, not to mention hinder patients’ access to care.
To holistically address the prior authorization problem facing the industry, we ideally need a combination of state and federal regulations, better prior auth technology, and forward-looking healthcare organizations that are willing to adopt new best practices. Take Oregon Health & Sciences University (OHSU), for example.
In our latest webinar, Valer CEO Dr. Steve Kim and OHSU’s Ryanne Laurence analyzed the prior authorization burdens that OHSU faced, focusing on specific portions of their workflow that would benefit from automation.
The OHSU Story
As a public academic health center, OHSU has a vast network of hospitals, clinics, and research facilities serving the community. In 2021, the health system struggled with maintaining different insurance and work queues, which took significant manual oversight. After auditing their workflows, they identified bottlenecks in their prior authorization processes that were putting an undue burden on the administrative staff and physicians alike. This looked like:
- Repetitive, redundant, error-prone tasks
- Limited visibility and access to the prior authorization continuum
- Staff frustration, morale, and turnover
Once OHSU identified the pain points in the prior auth process, the team worked to determine how and where an automation solution could fit into their operations. Not only did OHSU have specific checkboxes to mark in a technology partner, but the team had clear expectations for what successful implementation looked like.
Key Factors for Prior Authorization Success
OHSU had clearly defined measures to gauge the success of its prior authorization automation implementation:
- Ensuring there was a baseline measurement of where their prior auth processes were and how far out they were from seeing results
- Identifying the goals for automation, organization-wide
- Bringing the correct stakeholders to the table to make an informed decision, including workflow and IT subject matter experts.
- Understanding what training and rollout would look like once a partner was identified to streamline onboarding and staff utilization
- Partnering with a vendor who would continue to work with the organization to coach and empower staff to adapt to industry changes
Approaching Automation
After defining what success would look like as an organization, OHSU identified a list of necessities for an automation partner to bring to the table. Ultimately, OHSU determined that they needed a solution to integrate with their EMR, limit portal visibility to only those on their team, and customize their workflow. With that short list of specific asks, they set out to choose their automation partner.
Results, Powered by Valer
In 2021, public academic health center OHSU partnered with Valer for their prior authorization automation process. Valer meets the clearly defined needs of the organization to eliminate manual workflows, create operational efficiency, and eliminate duplicate work. By auditing its existing workflows, OHSU was able to articulate where automation could seamlessly fit within operations, making it easier for Valer to correctly tailor the solution to meet OHSU’s needs.
Since the partnership began, OHSU has seen impressive progress, including:
- 11% more prior auths performed with existing staff
- 45% reduction in processing time
- 160% improvement in prior authorization days out
To learn more about OHSU’s prior authorization journey and how your organization can gain similar workflow improvements, watch our webinar today: Meeting Patient Access Goals with Better Prior Auth Management
