Reports

Advancing Prior Authorization Automation Across Massachusetts

Written by Lauren Bedel, M.P.H | Apr 25, 2023 7:05:00 PM

Posted On April 25th, 2023

There is much evidence that automating prior authorization will ease many of its inefficiencies and irritations for payers, providers, and patients. A group of stakeholders in Massachusetts, including technical service providers and government regulators, focused on what it would take to automate prior authorization in the Commonwealth over the next two years. NEHI’s report, written in partnership with the Massachusetts Health Data Consortium, provides recommendations that anticipate the final Federal Rule on Improving Prior Authorization, including guidelines for drawing an automation roadmap and the structures needed to support the coordination and expertise needed for statewide implementation.

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Co-Authors

Project Sponsors

Project Participants

Berkshire Health Systems

Blue Cross Blue Shield of Massachusetts

Boston Children’s Primary Care

Alliance Change Healthcare

Centers for Medicare & Medicaid Services

Cohere Health

Community Care Cooperative

Counterpoint Solutions

Epic

Fallon Health

Health New England

Hook

John Glaser, PhD

Massachusetts Association of Health Plans

Massachusetts Executive Office of Health and Human Services

Mass General Brigham

Massachusetts Health & Hospital Association

Massachusetts Health Policy Commission

Massachusetts Medical Society

MassHealth

MEDITECH

Mt Auburn Cambridge Independent Practice Association

New England Quality Care Alliance

Office of the National Coordinator for Health Information Technology

Point32Health

Point-of-Care-Partners & HL7 Da Vinci

Reliant Medical Group

Steward Health Care

WellSense/Boston Medical Center Health System

ZeOmega