{"id":76587,"date":"2024-07-01T12:00:04","date_gmt":"2024-07-01T18:00:04","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=76587"},"modified":"2024-12-23T15:10:36","modified_gmt":"2024-12-23T22:10:36","slug":"arrive-health-takes-the-pain-and-time-out-of-prescription-prior-authorizations","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/arrive-health-takes-the-pain-and-time-out-of-prescription-prior-authorizations\/","title":{"rendered":"Arrive Health takes the pain \u2014 and time \u2014 out of prescription prior authorizations"},"content":{"rendered":"
<\/div>
\"Arrive
Arrive Health\u2019s comparison-shopping tool for prescription pricing has been saving UCHealth patients money on prescription costs for years. Now its system is speeding the prior-authorization process for drugs that require insurer approval, saving time and hassle for patients and providers. Photo: iStock.<\/figcaption><\/figure>\n

Arrive Health<\/a> has been helping providers and patients find the right medications at the best-possible prices for years<\/a>. Now it\u2019s drastically speeding up the prior-authorization process to get drugs that require an insurer\u2019s approval into patients\u2019 hands faster and more efficiently.<\/p>\n

A recent American Medical Association survey of 1,000 physicians found that care delays or abandonment related to prior authorization was \u201cwreaking havoc\u201d on patient outcomes, with 94% saying it delayed care. Roughly one quarter of those surveyed reported it sometimes led to patient hospitalization; 13% said it had led to life-threatening events or interventions to prevent impairment or damage; and 7% said it had led to patient disability, birth defect, or death.<\/p>\n

The prior-authorization system is working smoothly at three UCHealth clinics with the goal of rolling it out systemwide by the end of 2025, says Surabhi Palkimas, PharmD, UCHealth\u2019s pharmacy operation manager and a professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences<\/a>.<\/p>\n

\"Surabhi
Surabhi Palkimas, PharmD, UCHealth\u2019s pharmacy operation manager and a clinical assistant professor at the University of Colorado\u2019s Skaggs School of Pharmacy and Pharmaceutical Sciences.<\/figcaption><\/figure>\n

Arrive Health has been a UCHealth CARE Innovation Center<\/a> partner since 2016. UCHealth invested in the Denver-based health-IT firm and helped it develop a clinical decision support application that integrates with the widely used Epic electronic health record. (That\u2019s the engine behind UCHealth\u2019s My Health Connection<\/a> patient portal and much more.)<\/p>\n

The comparison-shopping tool has helped providers tailor medications to UCHealth patient needs, budget, and insurance coverage since 2019<\/a>, and it\u2019s now used by more than 300,000 providers and their patients nationwide, says Christie Callahan, Arrive Health\u2019s chief operating officer.<\/p>\n

More recently, Arrive Health worked with UCHealth to add an ability to cut the time it takes patients to get approval for a drug requiring prior authorization from three to five days to less than three days \u2013 and, often, within a single day, Palkimas says. That\u2019s relevant for a lot of patients. Among the pharmaceuticals frequently subject to insurer approval before prescriptions can be filled include GLP-1 receptor agonists such as Wegovy and Ozempic, albuterol asthma inhalers, lidocaine patches, and ADHD medications, she says.<\/p>\n

A better way to do prior authorizations<\/strong><\/h2>\n

Prior authorization has typically involved handoffs between physicians and other providers who prescribe medications, pharmacists, and pharmacy benefit managers such as CVS Caremark who work with health insurance plans to develop<\/p>\n

\"Arrive
Arrive Health Chief Operating Officer Christie Callahan.<\/figcaption><\/figure>\n

and administer pharmacy benefits. The handoffs took time, and they happened between different systems. The physician might not have known that a drug needed prior authorization in certain cases, which the patient might find out at a neighborhood CVS or Walgreens where the pharmacist would be unable to fill it. That meant frustration for patients and calls to providers to figure out what the holdup was.<\/p>\n

Now the prescribing provider can see in Arrive Health\u2019s Epic tool whether a drug requires prior authorization, and the patient also knows that right away. The prescription immediately lands in the UCHealth Pharmacy Authorization Center (PAC) queue via Epic. The pharmacy team can address the questions insurers need answered to authorize the prescription and send documentation to the right insurer, Palkimas says.<\/p>\n

\u201cThat all happens same day of receiving the request, and then the insurance company can get back to us, sometimes the same day, sometimes the very next day, so it cuts down the whole prior-authorization process,\u201d she said.<\/p>\n

\"Whitney
Whitney Vuchetich, medical director of UCHealth Lowry Internal Medicine and the CU School of Medicine\u2019s director of quality for General Internal Medicine.<\/figcaption><\/figure>\n

Speed hasn\u2019t been the only advantage of the Arrive Health prior-authorization system, says Whitney Vuchetich, a nurse practitioner and director of UCHealth Internal Medicine – Lowry<\/a> in Denver. Her clinic, along with UCHealth Primary Care – Briargate<\/a> and UCHealth Family Medicine – Boulder<\/a>, are live on the system. Vuchetich estimates that perhaps 15% of the prescriptions she writes channel into prior authorization. The system has helped keep patients apprised of prescription status, among other benefits.<\/p>\n

\u201cThe most important thing as far as how it\u2019s impacted my day-to-day workflow is actually being able to have a conversation with the patient,\u201d she said. \u201cPrior to this, we didn\u2019t often know what was going to happen after we entered the order and it left our screen.\u201d<\/p>\n

Patients know prescriptions are headed for prior authorization before appointments wrap up, and Epic adds a note to the after-visit summary reminding them as much, too.<\/p>\n

\u201cReally, from the provider standpoint, this really has not had downsides for us,\u201d Vuchetich said. \u201cIt\u2019s been a really positive experience.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Arrive Health has been helping providers and patients find the right medications at the best-possible prices for years. Now it\u2019s drastically speeding up the prior-authorization process to get drugs that require an insurer\u2019s approval into patients\u2019 hands faster and more efficiently. A recent American Medical Association survey of 1,000 physicians found that care delays or […]<\/p>\n","protected":false},"author":23,"featured_media":76595,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[493,63],"class_list":["post-76587","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-patient-experience","tag-pharmacy"],"acf":[],"yoast_head":"\nArrive Health is speeding up prescription prior-authorizations - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Arrive Health\u2019s comparison-shopping tool for prescription pricing saves UCHealth patients money on prescriptions. 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