• Q&A with Archie Mayani of Change Healthcare: A collaborative approach to automation

    Q&A with Archie Mayani of Change Healthcare: A collaborative approach to automation

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the prior authorization space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Through its namesake unified platform, Change Healthcare offers a suite of solutions designed to improve clinical and financial outcomes for providers, payers, and consumers across the care journey. Within the prior authorization space, Change Healthcare, which combined with Optum in 2022, offers eligibility and patient access tools to help providers more efficiently obtain pre-service authorization while creating additional financial transparency for patients.

    Archie Mayani, SVP and Chief Product Officer, leads Change Healthcare’s Clinical Decision Support business, where she oversees product development teams working to deliver evidence-based clinical content for payers and providers. Prior to joining the leadership team at Change Healthcare, she led Amazon’s Product and Content Operations team and led multiple teams at Optum. Archie began her career as a biomedical engineer, working her way through diverse product and business roles at GE Healthcare, Philips Healthcare, and Milliman Care Guidelines. She earned her master’s degree in biomedical engineering from the University of Florida and an MBA in Mergers and Acquisitions from the University of Warwick in the U.K.

    Q: Can you tell us about your company and the challenges you are solving within the prior authorization space?

    A: Change Healthcare is focused on enabling a better, more efficient healthcare system through the power of the Change Healthcare platform. Our goal is to help payers, providers, and consumers improve clinical and financial outcomes so that everyone in the healthcare system can thrive. Despite all the automation innovations that exist today, authorization automation remains a complex challenge. Although the industry has recognized some success, many gaps still exist that require costly human intervention. The manual nature of prior authorization, the need for clinical documentation, and payer connectivity are some of the challenges Change Healthcare is solving today.

    As part of our overall authorization solution, Clearance Authorization is an industry-leading module of our Clearance Patient Access Suite. Clearance Authorization determines if an authorization is needed. The solution houses authorization policies from more than 600 payers representing more than 90 percent of covered lives in the U.S. Its authorization policy database is routinely and automatically updated to ensure actions are taken on the most up-to-date set of payer policies, keeping the provider compliant with payer-authorization requirements. With Clearance Authorization screening rules, the provider increases productivity and reduces the cost of cumbersome manual touch points and time-consuming phone calls.

    Authorization Submission automates the manual process of prior authorization. The solution electronically submits the prior authorization request and monitors pending prior authorization decisions and updates the EHR or practice-management system. Today, we have EDI connections to more than 40 payers using the HIPAA required X12 278, and we use robotic process automation for 150 payer connections.

    To assist with the completion of inpatient medical reviews, hospitals use InterQual® AutoReview. This is a cloud solution for providers who want to apply AI to real-time data extracted from the EHR for patient-specific prediction and proactive insight while automatically completing the InterQual® medical review. This can reduce the manual entry of criteria by 70 percent on average and automatically complete some medical reviews without user intervention. This completed review, along with the clinical data, is shared with the integrated payer.

    In addition, the solution automatically obtains payer pre-authorization decisions from more than 175 payers and returns the approval and authorization number back to the EHR or practice management system as soon as they are available.

    Q: How does your company differentiate from other vendors in the same category?

    A: We are integrated with 15 different EHRs to automate authorizations and have a connected footprint of more than 150 payers and more than 2,000 hospitals. Our solution is the first scalable nationwide solution that leverages the InterQual content and the Change Healthcare Medical Network for payer integration and the sharing of clinical reviews. In addition, our clinical content team actively manages payer prior authorization rules and notifies providers when an authorization is required, reducing the unnecessary manual work at the beginning of the process. These rules are compared with claims and remittances that Change Healthcare processes to ensure that the rules are accurate.

    Some providers struggle with staffing that technology alone can’t address. Our Connected Authorization Services offering uses Change Healthcare authorization technology and our staffing expertise to help improve authorization efficiency. We deploy pre-authorization experts who use our intelligent authorization technology to help handle routine authorizations rapidly and work complex cases by exception to optimize the efficiency and accuracy of medical authorizations. This can be a fully outsourced solution or a hybrid approach, which gives providers the flexibility to build and scale capabilities to suit their specific needs, prevents unnecessary care delays, supports accurate reimbursement, and reduces the cost of medical authorization efforts.

    Q: What are some of the biggest changes your company has seen around how health systems are approaching prior authorization, given the changes in the landscape over the past couple of years?

    A: Health systems understand that there isn’t a silver bullet for authorizations and that no one vendor has connections to every payer or can automate every step in the process. Providers have complicated workflows because they work with many payers in multiple portals and with numerous vendors. Providers are looking at vendors who align with their vision of authorization and who they believe offer long-term solutions. They look for partners who work with payers and understand how to most efficiently solve the problem of prior authorization.

    Q: What does an ideal client look like? How are health systems or health plans best organized for success in standing up prior authorization and adjacent capabilities?

    A: For our authorization solution, there isn’t a single ideal customer. We work with nationwide health systems, community hospitals, as well as health plans. Some of our customers focus on specific provider use cases, such as ambulatory surgery centers, infusion centers, or vendors of durable medical equipment. Health systems that are well-suited for success with prior authorization typically have clear lines of communication and a strong focus on collaboration. This helps ensure that all relevant stakeholders are involved in the process and that there is a shared understanding of the goals and objectives. The customers who are organized for success understand that this is a partnership to address the authorization burden.

    Q: What measurable outcomes have you seen from your clients?

    A: The first step in our process is to compare authorization requests with our “Is Auth Required?” rules. Upfront recognition of whether an authorization is necessary offers significant time and cost savings. In most cases, we see that about 15 to 20 percent of the authorizations our solution receives don’t require authorization. Some providers see about a 40 percent reduction in authorizations with our authorization screening tool. In addition, customers have seen up to 70 percent of their authorizations benefit from some level of automation with their payers. This number is based on the provider’s payer mix and set of services.

    InterQual AutoReview offers a unique blend of AI, automation and evidence, which helps case managers be more efficient, proactive, and insights-driven to improve clinical and financial outcomes. Real-time predictions are delivered when it matters most and are continuously updated throughout the patient’s stay. This automation eliminates 75 percent of the work required for the initial clinical review process.

    For Clearance Authorization status updates, our solution has found the final determination for more than 70 percent of our customers’ prior authorization requests. This metric is dependent on the specific payers and services for the provider.

    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of automation?

    A: This spring, we will expand our integration for single sign-on using Smart on FHIR integration. This is a move to add FHIR APIs to our existing 278 and HL-7 integration options and will allow users to stay within their EHR workflow. The solution uses our application for FHIR connections to gather clinical data from the EHR as part of the submission, reducing the manual process of uploading documents. Our integration with payers is also expanding with direct API integration for the Da Vinci FHIR CRD and DTR workflows, as well as the addition of the InterQual Medical Review Service feature Review Share, which allows connected providers to electronically share InterQual Medical Reviews with their connected payers. Further payer integration to support more clinical documentation uploads and faster approvals will also be offered.

    Q: How is your company partnering with clients as reimbursements and use cases shift?

    A: Our authorization conversation starts with understanding the provider’s needs. Are they looking for a technology solution for their staff, a service offering to reduce their costs, or a hybrid model to allow for scale and flexibility? We build on this solution by discussing specific use cases (inpatient, ambulatory, or specific service lines), and then we add our integration with payers. In many cases, we work jointly with payers and providers to solve the authorization workflow together.

    Q: What are the biggest opportunities health systems should be thinking about this year when it comes to automation?

    A: With the newly released CMS proposed rule and the mandate for inclusion of new standards for electronic authorization, now is the time for discussions with vendors on the prior authorization road map and how they believe they and the market will respond. These conversations should include means of reducing the amount of time and resources spent on manual prior authorization processes, improving the accuracy and completeness of prior authorization submissions, and increasing overall efficiency and productivity. By focusing on these opportunities, health systems can improve their prior authorization processes while improving the patient experience.

    Q: How do you see the prior authorization space evolving in the next two to five years and beyond?

    A: The new proposed rule published by CMS in December 2022 aims to overhaul prior authorization by streamlining requests and the sharing of healthcare data. These new authorization requirements should align providers, payers, and vendors to address the prior authorization burden. This requirement for Medicare Advantage, Medicaid, and exchange plans mandates that electronic prior authorization be built around the X12 278 HIPAA standard, supplemented with APIs for sharing of the medical guidelines, electronic submission of prior authorizations, and to know when an authorization is required. The CMS requirement focuses on reducing the burden of prior authorization. Companies with payer and provider integration along with medical guidelines and automation tools will be the partners that health systems will want to work with in this quickly evolving landscape.

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    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Patty Riskind of Orbita: Combining automation with empathy

    Q&A with Patty Riskind of Orbita: Combining automation with empathy

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the patient education space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Orbita’s conversational AI platform powers voice, text, email and chatbot-based digital care solutions to support patients during their care journeys, reduce care team workload, and close gaps in care. Providers can deploy HIPAA-compliant virtual assistants and conversational AI to guide patients through the care journey, from a digital front door to continuous follow-up with clinical escalations. Founded in 2015, the Boston-based Orbita attracted Philips Health Technology Ventures and HealthX Ventures as lead investors in its series A round.

    Chief Executive Officer Patty Riskind is a dynamic healthcare tech leader whose previous leadership experience includes serving as Head of Global Healthcare for Qualtrics and as Press Ganey’s Chief Client Experience Officer. She received her undergraduate degree from Brown University and earned an MBA from the Kellogg School of Management at Northwestern University.

    Q: Can you tell us about your company and the challenges you are solving within the patient education space?

    A: Orbita embraces an all-encompassing view of patient education–we believe that education should be viewed as the objective and outcome of virtually any patient interaction. It includes not only education about diseases, conditions, and treatment, but also guidance for patients to help them effectively engage with the health system and clinical staff before, during and after encounters.

    For example, patients are often at a loss about how to find the best provider and level of care. Health system websites are seldom configured to deliver simple guidance and easy-to-find education. Too often, consumers and patients don’t know where to start–the search bar? The chatbot? The “Find a Doctor” button?. And though patients may be able to find and use these functions, they may not know how to phrase their questions in clinical terms. As a result, website visitors rarely get the specific information and direction they seek, and often abandon the search out of frustration or end up having to call to find what they need.

    Orbita has introduced Blaze, a solution that uses conversational AI to transform limited search tools into a genuinely intelligent virtual assistant. When patients–or prospective patients–interact with Blaze, they engage in a web-based dialog with a virtual assistant that asks questions to help narrow and define their search. For example, Blaze probes for details about symptoms, so the individual can be directed to the right care setting–urgent care versus the ED, for example, or a next-day primary care visit if that is appropriate. Blaze translates how a layperson might ask about a certain type of doctor (e.g., a foot doctor) and knows that the patient means a podiatrist. Blaze applies 20 query classifications, increasing the accuracy and likelihood of matching the patient with the right information.

    Not only does Blaze improve the patient experience when they engage with a health system’s website, it also increases conversion because it integrates with a health system’s scheduling system, further reducing the need for phone calls.

    Intelligent digital tools can meet a wide range of patient needs in a consumer-friendly manner, which more and more patients expect when they seek care. Orbita offers automated intake and procedure prep instructions, so patients know what to expect from visits and treatments and are better equipped to manage their conditions. In addition, Orbita virtual assistants can support follow-up care and remote patient monitoring in order to keep patients engaged and informed while gathering key information to improve outcomes.

    Q: How does your company differentiate from other patient education solution vendors?

    A: Orbita offers the industry a robust platform to support automated interactions across the patient’s care journey. Pre-built solutions, which range from Patient Self-scheduling toContinuous Care Follow Up, allow Orbita clients to leverage intelligent automation that reduces staff time and improves patient engagement. Orbita’s platform is healthcare-specific, configured to work and communicate the way that healthcare does. It is HIPAA-compliant and maintains industry-standard certifications including ISO 27001, ISO 27701, SOC 2 Type II and Privacy Shield. We’re also in the process of obtaining HITRUST CSF certification.

    Our digital tools are built to understand natural language, so patients can use familiar words and phrases. Conversational AI guides dialogs to deliver education, information and guidance relevant to each patient’s situation. Plus, Orbita offers integrated multichannel functionality, deploying its virtual assistant across web, text, voice (IVR) and smart speakers, so patients can interact in the manner most comfortable for them.

    Q: What are some of the biggest changes your company has seen around how health systems are approaching patient education since 2020?

    A: The most prevalent trend is the rapid acceleration of consumer-centric digital approaches. Patients have become used to digital tools and self-service options in other areas of their lives and now demand the same in healthcare. They want access to information and the ability to ask questions, schedule appointments, and manage their care with the methods they are most comfortable with, including phone, SMS, email, or smart speaker. Health systems need to meet patients where they are and provide easy to use tools to inform, educate and engage.

    Q: What does an ideal client look like? How are health systems best organized for success in advancing their patient education capabilities?

    A: The ideal Orbita client realizes that greater automation benefits both the patient and the organization. At the same time, they don’t want to compromise on the empathy that characterizes healthcare. These organizations seek technology partners to help them adopt digital tools that exhibit both convenience and compassion. Often, these organizations have started down a digital-first path, recognizing that virtual assistants don’t replace human interaction, but augment them.

    Q: What measurable outcomes have you seen from your clients?

    A: Orbita solutions are applied across a variety of use cases, driving specific results according to each health system’s objectives.

    • A large, Midwestern academic healthcare system used Orbita outreach solutions to educate and guide frail elderly patients through a regular exercise program after discharge. Over 10 weeks, grip strength among participants increased 70 percent and their ability to complete five repeated chair stands improved by 89 percent. No patients were readmitted.
    • A mid-Atlantic system deployed a multi-channel (cascading across email, text, and voice) Orbita patient outreach campaign to monitor status post-discharge. The program achieved 86 percent patient engagement. A brief automated survey verified that 68 percent of patients improved according to expectations, meaning that nursing staff only needed to reach out to 32 percent instead of the full cohort.
    • One Orbita client recently deployed the solution to ensure that referrals made during urgent care visits were scheduled. Using automated SMS messages, this provider saw a 23 percent increase in scheduled referral appointments. The messages were sent 24 hours after the urgent care visit and included the provider’s contact information and a link to book follow-up appointments.
    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of patient education?

    Our priorities for 2023 are three-fold:

    • Building out our Blaze functionality so patients can self-serve and find precise information and guidance through provider websites. We see ample opportunity to vastly improve the current status of healthcare searches by marrying the best of Google-like functionality with a smart and empathetic virtual assistant.
    • Refining and expanding the Orbita Patient Self-scheduling solution. This helps healthcare providers respond to patient demand for consumer convenience (like Uber or Open Table) and helps organizations reduce leakage if patients find it easier to schedule appointments, services, or procedures elsewhere. This will become increasingly important as retailers like Walmart and Amazon enter healthcare delivery.
    • Supplying health system clients with dashboards and detailed analytics so they can measure and improve the way they engage and educate patients and see how their digital tools elevate the patient experience and enhance outcomes.
    Q: What are the biggest opportunities that health systems should be thinking about this coming year when it comes to patient education?

    A: Health systems must acknowledge that their patients are, in actuality, customers, and treat them as such. That means delivering information in ways and across channels that are most convenient for the individual, not the organization.

    Q: How do you see patient education evolving in the next two to five years and beyond?

    A: We anticipate continued momentum toward digital-first, including continued growth of automated and live interaction hybrids. Health systems would be well-served to begin thinking about a long-term, enterprise-wide strategy to provide the best experience for their patients. This approach also ensures that organizations operate efficiently and effectively, and are able to capture revenue that might otherwise be lost.

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    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Christie Callahan of Arrive Health: Putting patient-provider relationships first 

    Q&A with Christie Callahan of Arrive Health: Putting patient-provider relationships first 

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the prior authorization space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Arrive Health developed its care access platform to aggregate, normalize, and display real-time data from healthcare content providers in order to promote cost transparency, reduce administrative burdens, ensure patients receive the care they need, and inspire meaningful conversations about care costs and options. Care teams can use Arrive Health’s solutions to review eligibility and accurate pricing information at the point of care within the clinical workflow, with real-time notifications about coverage restrictions and automated prior authorization initiation; while patients receive targeted messages at key moments to drive better decisions and outcomes. Previously known as RxRevu, Arrive Health was originally founded to promote insurance coverage transparency and drive cost-effective prescribing.

    In her role as Arrive Health’s Chief Operating Officer, Christie Callahan is responsible for operations and developing new solutions to reduce prescribing friction and increase access to care. Christie has worked in the pharmacy space for over a decade, focusing on interoperability, technology innovation, and process improvement. During her career, she has developed transformation strategies for a number of large healthcare companies, including specialty and mail order pharmacies, prior authorization departments, and call centers. Prior to joining Arrive Health, Christie served as Vice President of Strategy and Innovation for Members Services at CVS Health and as a consultant at Bain and Company. 

    Q: Can you tell us about your company and the challenges you are solving within the prior authorization space?

    A: At Arrive Health, the patient-provider relationship is our true north. Our solutions leverage accurate, patient-specific data to help providers reach the best decisions with their patients. With real-time notifications for coverage restrictions and prior authorization details, as well as automatic initiation of the electronic prior authorization (ePA) process, providers can significantly reduce administrative burden and ensure transparent communication with patients and care teams. Our directly connected network combines real-time prescription benefit data (from payers and PBMs) with automated ePA capabilities to reduce provider burden, improve patient engagement, and speed time to therapy.

    Q: How does your company differentiate from other vendors in the same category?

    A: Arrive Health is more than simply a pipeline for ePA transactions. We have built a unique intelligence layer to confirm patient coverage, recommend covered medication options, and match question sets and responses whenever possible. This intelligence layer enables our three main patient and provider-centric goals:

    1. Keep patients on-formulary and avoid unnecessary prior authorizations whenever possible.
    2. Maximize automation and electronic channels to minimize manual data entry and speed time to resolution.
    3. Complete prior authorizations before the prescription hits the pharmacy to eliminate patient disruption and promote medication adherence.

    By solving these problems, we eliminate thousands of faxes, phone calls, and duplicative work for providers and care teams, along with patient dissatisfaction from delays or denials.

    Q: What are some of the biggest changes your company has seen around how health systems are approaching prior authorization, given the changes in the landscape over the past couple of years?

    A: Health systems want a better solution to prior authorization, but in the past, manual and out-of-workflow ePA solutions have failed to deliver. As a result, this is an area where the appetite for experimentation is low. Further, key ePA players have been stagnant in optimizing the PA process for providers, care teams, and patients.
    Overall, they seek two requirements that many solutions fail to deliver:

    1. Complete network coverage, with one solution for every patient and medication.
    2. Immediate labor savings–automation justifies a change in approach.

    Health systems are in the midst of a labor crisis and are hungry to improve the broken prior authorization process–with the right partner.

    Q: What does an ideal client look like? How are health systems or health plans best organized for success in standing up prior authorization and adjacent capabilities?

    A: Our ideal clients recognize the opportunity to drive change and are motivated to act. We’re looking for innovation partners that deeply understand the current state problems, and are ready for an ePA solution that serves providers. Our vision is an end-state that maximizes PA avoidance and automates data/question-set population, leaving only a simple review prior to submission.

    Q: What measurable outcomes have you seen from your clients?

    A: Today, our health system partners avoid prior authorizations nearly 32 percent of the time. Our integrated point-of-care tools alert providers about covered care options, which allows them to take meaningful action to avoid unnecessary PAs. These initial results led to partnerships with two nationally renowned health systems to partner in order to further transform ePA and develop an end-to-end solution, with initial launch planned in 2023.

    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of automation generally?

    A: Arrive Health’s core capability is building intelligent automation networks that bring together disparate data sources to improve patient access to care. As a result, we are constantly expanding our capabilities and investing in our approaches and architecture. We have already built networks between the nation’s largest payer/PBM databases and health system EHR workflows. Through these networks, we automatically deliver patient-specific cost, coverage, and medication alternative information. By adding in prior authorization functionality, we are expanding on the support we deliver to providers, care teams, and patients.

    Q: How is your company partnering with clients as reimbursements and use cases shift?

    A: We believe that to disrupt prior authorization, we must align ourselves with providers. Market solutions exist to serve payers and manufacturers, but direct service to providers is the way to drive true differentiation. Additionally, Arrive Health has taken on a number of investors, all of whom are health systems or their innovation arms (UCHealth, Providence, UnityPoint, Froedtert, UVA Health, and more). These partnerships further strengthen our focus and commitment to provider workflow improvement and products that support providers.

    Q: What are the biggest opportunities health systems should be thinking about this year when it comes to automation?

    A: Early in 2023, we acquired pharmacy automation technology from UPMC Enterprises to engage and support patients more holistically, while driving ongoing adherence. This technology can offload tasks from pharmacy teams so they can prioritize patient care. 

    Beyond that, the primary opportunity is  prior authorization. Automation is more necessary than ever to relieve pressure created by labor shortages, and prior authorization is an area where many skilled resources are required for administrative activity. This is not an area to minimize or ignore for health systems as they chart plans for investment in automation tools. By automatically initiating the prior authorization process and proactively streamlining question sets and submission, we can reduce administrative burden and use automation to our advantage.

    Q: How do you see the prior authorization space evolving in the next two to five years and beyond?

    A: In the next two to five years, we will see real change in the prior authorization space. The combination of regulatory and market pressures are creating an environment where the status quo cannot persist. The key for health systems will be to identify partners that have the capabilities to drive transformational solutions and the organizational alignment to do so on behalf of providers.

    Don’t miss another Q&A—subscribe to AVIA Marketplace for updates.

    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Siva Namasivayam of Cohere Health: The role of prior authorization in a holistic approach to care 

    Q&A with Siva Namasivayam of Cohere Health: The role of prior authorization in a holistic approach to care 

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the prior authorization space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Cohere Health’s intelligent prior authorization solution is configurable to the needs of individual health plans, and can be implemented as a licensed platform (Cohere Unify™) or as a fully outsourced utilization management service (Cohere Complete™). Cohere’s solutions enable end-to-end automation of prior authorization that not only digitizes the process, but adds a layer of clinical intelligence that nets administrative efficiencies for payers and providers and better outcomes for patients. With a customizable methodology, Cohere’s solutions improve provider experiences, reduce administrative burden, and drive more automated real-time decisions with accelerated clinical review while smoothly integrating into provider and health plan system’s prior authorization workflows.

    CEO Siva Namasivayam is a technology and healthcare veteran with over 20 years of experience utilizing technology and data to improve healthcare processes. Prior to co-founding Cohere, Namasivayam was a founding partner of SCIO Health Analytics, which served over 50 Fortune 500 healthcare organizations. He holds a master’s degree in computer science from the University of Pittsburgh, as well as an MBA from the University of Michigan.

    Q: Can you tell us about your company and the challenges you are solving within the prior authorization space?

    A: Prior authorization, or PA, remains a massive administrative burden for health plans and their provider partners, and often delays patient care. It also represents an untapped opportunity to improve patient care journeys and enable more successful value-based care arrangements.

    The Cohere Unify™ solution suite automates prior authorization intake and decisioning to drive administrative efficiency, while adding clinical intelligence to speed and improve patient outcomes.

    Our intelligent prior authorization solutions leverage an innovative blend of AI and machine learning, clinical expertise, and real-time analytics to shift the framing of prior authorization and concurrent review from transactional to transformational. By orienting service requests within the context of the broader patient journey and applying learning from health plan data, health plans can leverage utilization management to improve the provider experience and patient access to quality care.

    In addition to reducing administrative time, cost, and abrasion, our solutions offer these capabilities:

    • Care path generation, to enable collaboration on a patient-specific treatment plan designed to produce the best and fastest outcome.
    • Pre-submission influence, to help guide optimal care choices before requests are submitted, such as shifting site-of-service.
    • Episode-based authorization, to leverage care path technology to approve an entire set of services upfront.
    Q: How does your company differentiate from other vendors in the same category?

    A: Cohere Unify™ intelligent prior authorization solutions enable end-to-end automation of prior authorization with digitization and the addition of clinical intelligence. As a result, our client health plans achieve significant administrative savings and better, more efficient patient outcomes.

    Cohere’s differentiators impact patients, providers, and health plans alike:

    • Faster, better patient outcomes
      • Patient-specific reviews
      • Pre-submission influence
    • Less abrasive provider experiences
      • Request consolidation
      • Accuracy assurance
      • Immediate processing
    • More efficient, less costly health plan operations
      • Automated plan policy
      • Manual review pre-processing
      • Real-time analytics
    Q: What are some of the biggest changes your company has seen around how health systems are approaching prior authorization, given the changes in the landscape over the past couple of years?

    A: The process of securing advance approval from a health plan for a test, medication, or surgical procedure is often problematic for physicians and their patients. Prior authorization is still a largely manual process, which requires providers to fax forms and clinical notes to multiple health plans, each with its own authorization processes and coverage policies.

    Over the past five years, the push to mandate the implementation of electronic PA has gained new traction through state and federal legislative efforts. Members of the 117th U.S. House of Representatives passed legislation that would affect the future of PA for Medicare Advantage (MA) plans. The Improving Seniors’ Timely Access to Care Act was intended to reduce providers’ administrative burden while improving the speed of patient access to necessary care.

    In December 2021, The Centers for Medicare & Medicaid Services (CMS) proposed a new rule to advance interoperability and improve prior authorization for Medicare and Medicaid patients. CMS’ new rule includes public feedback from a former iteration of the rule, proposed back in December 2020 and would place new requirements on Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) fee-for-service programs, Medicaid managed care plans and CHIP managed care entities, and qualified health plan issuers on federally facilitated exchanges. 

    Electronic PA is a good start, but it is not enough. To have a significant impact on the cost and quality of care, health plans must adopt intelligent technology that gives providers meaningful support to help achieve the fastest and best possible outcomes for patients.Cohere’s intelligent authorization solutions can easily exceed the legislative requirements for greater automation, transparency, and accelerated approvals by utilizing evidence-based clinical criteria that are clearly defined and referenceable for physicians. Improved transparency and interoperability can reduce the friction between health plans and their provider partners. Prior authorization facilitates this communication, making it clear which services require approval, what documentation is necessary, and citing national medical society’s standards of care encouraging physicians to follow a high-value recommendation for a particular site, service, or test.

    MA plans are committed to improving clinical outcomes and provide members with access to the most appropriate health care services. To that end, MA plans should adopt broader perspectives on utilization management in order to better serve their members and allow PA to function as a benefit instead of a roadblock.

    Q: What does an ideal client look like? How are health systems or health plans best organized for success in standing up prior authorization and adjacent capabilities?

    A: Health plans are facing increased pressure from providers, regulatory institutions and patients to fix the problems associated with prior authorization. Since utilization management solves an unavoidable problem, health plans should instead leverage utilization management as an asset to improve care delivery. By using advanced technology to leverage health plan data, our solutions transform the transactional process to a longitudinal one.

    When physicians and health plans consider individual services within the context of care paths, they can align around longitudinal, quality care that is evidence-based and patient-specific. Solutions that harness health plan data and incorporate it with up-to-date clinical guidelines can leverage prior authorization as a tool to decrease care variation and drive medical expense savings. With this stronger focus on quality, health plans can respond to pressures and more effectively align themselves with value-based care models.

    Q: What measurable outcomes have you seen from your clients?

    A: Cohere Health serves more than 15 million members, and our intelligent prior authorization platform is used by more than 197,000 providers across all 50 states to submit and manage authorization requests.

    Cohere delivers incremental medical cost savings while reducing denial rates by 63 percent. That’s because 64 percent of our impact on utilization comes from non-denial techniques, such as “nudges,” which promote appropriate care choices before the authorization request is submitted. Thanks to this unique approach, our process drives higher provider satisfaction, as represented by a very high net promoter score (NPS) of 55. In addition, 96 percent of the prior authorizations are submitted digitally through our platform, and patient access to care is expedited by 70 percent.

    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of automation generally?

    A: Recently, state and federal regulators moved forward with legislation to standardize the prior authorization process and reduce provider burden, including the implementation of gold carding efforts. Gold carding takes a provider’s authorization history for certain services and, if it meets a certain percentage approval threshold, exempts them from authorization requirements for those services going forward. But legislative efforts like gold carding are not enough on their own to address the challenges of prior authorization. Health plans require advanced solutions to provide the technological scaffolding to comply with legislation and truly transform utilization management.

    The Cohere Unify™ platform has a more comprehensive capability than gold carding: green lighting. Green lighting goes beyond clinical assessment question modification and instead rewards high-performing providers. Using machine learning, green lighting predicts providers’ actions and decisions to simplify the authorization process without compromising the approval and delivery of evidence-based quality care. The green lighting approach allows health plans to meet compliance requirements for gold carding and move to a more advanced standard of care. Green lighting can link authorization decisions to provider tiers to programmatically implement gold carding requirements.

    Beyond the regulatory landscape, intelligent prior authorization uses clinical nudges to deliver better care quality for patients. By looking at the longitudinal patient record, technology can collate authorization history for patient cohorts to be measured against general population health data and use it to inform these nudges. Clinical nudges can be used to suggest low-cost, high-performing care alternatives and other services that may be eligible for auto-determining, and streamline the authorization process to promote quicker access to quality care.

    Q: How do you see the prior authorization space evolving in the next two to five years and beyond?

    A: This next generation of intelligent prior authorization is the first step toward the transition to value-based care, in which a service request is oriented within a larger care journey and its ability to impact the patient’s overall health. By uniting providers around the common goal of providing value and better patient health outcomes, value-based systems create healthy competition in the healthcare space and drive down medical costs.

    Health plans that use intelligent prior authorization leverage patient, provider, and regional population data to orient prior authorization service requests within each member’s care journey. These health plans are much better positioned to face this changing landscape. Machine learning that suggests clinically optimal care and accounts for social determinants of health, combined with prior authorization and intelligent decisioning, can help shift the focus away from single service requests and toward a more holistic approach to patient care.

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    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Brennan Stratton of Krames: Education as a core component of care

    Q&A with Brennan Stratton of Krames: Education as a core component of care

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the patient education space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Krames’ patient education and health literacy solutions were created to standardize education, meet compliance goals, and improve the patient experience, with materials available in a variety of formats and languages to meet patients wherever they are. Clinical education is developed at a fourth to sixth grade reading level, with engaging visual content to support learning objectives, and is available in 17 languages. Patients can receive critical education wherever they are with solutions that enable delivery through mobile devices, hospital televisions, and even traditional printed materials, with more than 600 available titles across 40 specialties.

    Brennan Stratton serves as the Vice President of Sales and Client Services for WebMD Provider Services Clinical Solutions, including the Krames business. In this role, Brennan leads the sales, implementation, and account management functions for Krames. He has more than 14 years of experience selling and leading sales and account management teams within the healthcare IT and patient engagement sectors. Previously, Brennan worked for Elsevier and RelayHealth, a division of McKesson. He earned his undergraduate degree and MBA from the University of Georgia.

    Q: Can you tell us about your company and the challenges you are solving within the patient education space?

    A: Krames is part of WebMD Provider Services, which is a full-service strategic marketing and patient engagement solution provider, geared specifically for healthcare.

    Our Krames patient education solutions help providers meet the priorities of the Quintuple Aim: Clinician well-being, health equity, improving population health, enhancing care experience, and reducing overall costs.

    More specifically, our patient education content collection–including HealthSheets, ExitWriter, and HealthClips, plus partner content from VUCA, American Heart Association, ViewMedica, FDB and KidsHealth–support health systems’ quality, compliance and equity goals. In addition, our assignment platforms support clinical efficiency with the ability to assign education within the clinical workflow. Our assignment platforms range from a full FHIR implementation via an Electronic Health Record platform (Krames On FHIR®) to a stand-alone on-demand system (Krames On-Demand®).

    Q: How does your company differentiate from other patient education solution vendors?

    A: Everything we do at Krames is intended to create a more seamless and personalized patient and consumer experience through an omnichannel approach. Krames’ industry-leading content, digital engagement tools, combined with WebMD’s ability to reach consumers at all points of the care journey, allows us to deliver truly personalized education. Our goal is to provide highly relevant, personalized, and engaging content, employing a variety of media and styles, to empower health consumers to be active and informed in their care.

    Q: What are some of the biggest changes your company has seen around how health systems are approaching patient education since 2020?

    A: The COVID pandemic hastened a shift toward consumerism in healthcare, so today’s patients expect a more streamlined, connective and responsive experience when they seek care. To meet those needs, patient education had to shift from being a static tool to “check the box,” relegated to meeting compliance and quality initiatives at the point of care, to a personalized, responsive, and even proactive experience.

    To respond to this market shift, our education and information is developed to effectively engage individuals making decisions about and seeking care, enhance the provider-patient dialogue at the point of care, and provide supportive outreach and intervention that can activate individuals in their ongoing care management and recovery.

    Last, I’d say that traditional patient education is increasingly becoming a core component of a broader patient journey and digital engagement strategy. So we’re thinking about how we tie content across all points of interaction.

    Q: What does an ideal client look like? How are health systems best organized for success in advancing their patient education capabilities?

    A: Krames works with organizations across the healthcare industry, including health systems, health plans, emerging care models and provider networks. We’ve seen a few common approaches that have helped organizations succeed: Establishing a cross-functional governance team, deploying tools that help the organization better understand its patient population, and not buying into a ‘one size fits all approach’ to patient education. It’s important to deploy education that reaches patients in different formats and at all points in their journey.

    Health systems are best organized for success when they’re focused on providing cohesive, consistent outreach and communications and are looking for solutions that make it easy to provide the right information at the right time. So our approach is to offer modular solutions that can scale with health systems as they expand their efforts.

    Q: What measurable outcomes have you seen from your clients?

    A: Most notably, the majority of our customers have higher Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and lower lengths of stay compared to their local competitors. In addition, our customers have noted improved nursing satisfaction, lower readmission rates, and greater patient acquisition, loyalty, and retention.

    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of patient education?

    A: As part of our core offering around our assignment platforms, we’ll continue to invest in industry-leading EHR integrations and enhancements to Krames On FHIR®.

    We’re also expanding our education into platforms and modes that patients use and clinicians prefer, like SMS/texting. Using an omnichannel approach, we are building relationships with various distribution partners to ensure we can reach individuals at critical times with the most appropriate messages on their preferred methods for engagement.

    Additionally, we are working to better leverage data–through the broad variety of tools within the WebMD family–to help personalize interactions with health consumers.

    Q: What are the biggest opportunities health systems should be thinking about this coming year when it comes to health consumer education?

    A: I think the biggest opportunity is really around personalization and understanding individual health consumer needs and how your health system can best reach health consumers in different and meaningful ways.

    Personalization opportunities include the content used throughout healthcare consumers’ engagements across their discovery to recovery journeys, as well as the tools and platforms used throughout their experiences to ensure they are presented with the right information in a way they prefer to engage with it.

    Healthcare is incredibly personal and can be emotional. The systems that meet individuals’ needs holistically across their journey will see success. And Krames is committed to solutions that meet the needs of individuals in a highly personalized way.

    Q: How do you see patient education evolving in the next two to five years and beyond?

    A: In terms of patient education, we see it evolving to cater to individual patient needs and the way each patient learns best. That entails knowing where health consumers are in their understanding and helping them feel more confident and empowered in their journey.

    But the broader vision for us as part of WebMD Provider Services is to take what is commonly a complicated, disjointed and difficult experience to navigate, and employ a variety of modular solutions aimed at engaging health consumers at critical points in their care.

    By bringing together our collective solutions, built using the expertise of outreach and digital engagement of WebMD, rich data and insights of Mercury Health, and the depth of knowledge of provider support from Krames; we provide highly personalized experiences that support the Quintuple Aim.

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    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Adam Husney of Healthwise: Patient education with a mission

    Q&A with Adam Husney of Healthwise: Patient education with a mission

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the patient education space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Since its founding in 1975, Healthwise has earned a reputation as one of the most respected patient education companies in the industry, with a broad portfolio of solutions to inform healthcare consumers at all points across the care continuum. Healthwise solutions enable physicians to deliver health education at the point of care, with content that includes instructions, videos, and decision support tools for patients. Health systems can also use Healthwise content to augment their content libraries, support digital care journeys, and implement standards-based education. All content reflects current standards of care and is designed to help providers and payers meet patients exactly where they are. 

    CEO Adam Husney, M.D. has advocated for patients to take active roles in their health throughout his entire career. As CEO, Adam works with Healthwise product managers and clients from the provider and payer industries to create products that meet their workflow needs. He also collaborates with Healthwise’s behavior change and plain-language experts to build products to help people make the right healthcare decisions for themselves. A physician by training, Adam received his bachelor’s degree in neuroscience from Brown University and his medical degree from the University of Pennsylvania. After completing his family medicine residency at the University of Michigan, he has practiced in New Hampshire and Idaho. 

    Q: Can you tell us about your company and the challenges you are solving within the patient education space?

    A: Healthwise was founded in 1975 as a nonprofit with the mission “to help people make better health decisions.” Healthwise partners with hospitals, health plans, health portals, and technology companies to fulfill that mission by providing the health education content they need, the technology to deliver it, and the expert services to ensure continued success.

    The problems we solve:

    • Healthwise content. Building patient trust has never been more critical. Healthwise provides the most up-to-date, accurate, and evidence-based patient education. Our education is personal, engaging, and empowers patients throughout their patient journeys.
    • Healthwise technology. Healthwise provides a consistent singular source of patient education across the care continuum. Our technology solutions make that education available through easy integration with complex health IT systems and healthcare solutions. 
    • Healthwise service. Healthwise team members believe in our mission and bring that energy into their jobs every day. Our service to clients differentiates us. After 47 years, we have a deep understanding of the patient education and clinician experience, and work hard to solve the unique challenges that organizations face at the point of care.
    Q: How does your company differentiate from other patient education solution vendors?

    A: Healthwise is a fiercely independent nonprofit with a singular focus on unbiased health education and a responsibility only to the people we serve. Our mission influences our decision-making, not shareholders, and that lets us do what’s right for patients every time. 

    True to our mission, we invest in making the best health education to help people live healthier lives. Healthwise has unmatched breadth and depth of content including over 8,500 health education topics, more than 800 videos, and support for 19 languages. Healthwise educational content is user-tested and optimized for patient engagement, including reading level, content structure, and content length. Our teams put special focus on improving health literacy with plain language and low-text, highly visual health education. 

    Our dedication to health equity, diversity, inclusion, and addressing social determinants of health means that we constantly improve and update our materials to engage, represent, and support all people in their healthcare journeys. 

    Q: What are some of the biggest changes your company has seen around how health systems are approaching patient education since 2020?

    Global health events like COVID-19 have shown how critical it is to have accurate, evidence-based patient education. Content must keep up with the flow of new information and be regularly updated to earn and maintain public trust.

    To use that education effectively, hospitals and health systems need it to seamlessly integrate into existing technology and provider workflows, with regular updates that don’t create new IT and operational burdens.

    Finally, shifting sites of care, such as increasing virtual care and telehealth, have made consistent patient education experiences across the care continuum even more important.

    Q: What does an ideal client look like? How are health systems best organized for success in advancing their patient education capabilities?

    A: Our ideal client shares our mission to give patients the information and tools that they need to drive their own health. They believe that education plays a critical role in empowering the patient, improving outcomes, reducing costs, and improving clinician satisfaction. And they’re committed to investing in patient education governance and programs to use patient education effectively.

    Q: What measurable outcomes have you seen from your clients?

    A: Generally, we’ve been able to measure positive outcomes connected to our education including:

    • Reduction in readmission rates 
    • Workflow efficiencies and time savings  
    • Clinician satisfaction 
    • Patient decision-making and satisfaction (including general fluency in understanding healthcare conditions) 

     

    Healthwise also has a strategy and analytics team that supports clients, partners, and health researchers in their quality improvement research. We can help identify opportunities for quality improvement with data, assist with data identification and analysis, and support funded research and student projects. We then help to highlight and disseminate these projects with our network of client organizations across the United States.

    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of patient education?

    A: Healthwise is focused on a number of product enhancements, including support for health literacy and health equity; content and product developments that support social determinants of health; and interoperability, as seen in our recent release of Healthwise Advise, our point of care solution for Epic users.

    Q: What are the biggest opportunities health systems should be thinking about this coming year when it comes to patient education?

    A: Two opportunities health systems should be thinking about are:

    1. How education can help them reach diverse and underserved populations in their communities.

      Reaching diverse and underserved populations is important to ensure that everyone has equal opportunity to receive quality health care. Additionally, low health equity impacts outcomes and increases costs for patients, hospitals, and health systems. For example, more than one-third of U.S. adults have low health literacy. Compared to those with proficient health literacy, adults with low health literacy experience:

      • Four times higher health care costs
      • About 6 percent more hospital visits
      • Hospital stays that are two days longer

      And low health literacy isn’t just a problem for patients who don’t get the care they need—it’s a problem for health care organizations. Low health literacy is estimated to cost the U.S. $236 billion annually. Education can help by improving comprehension and communication.

    2. How a consistent voice of education can bridge their shifting sites of care.
      As populations change and become more complex, how do health systems reach patients? Your patient population is in many different places, so it’s important to make sure they receive a consistent experience everywhere they interact with your health system. As sites of care diversify, offering consistent education helps ensure a consistent patient experience.
    Q: How do you see patient education evolving in the next two to five years and beyond?

    A: Education will be increasingly used as an intervention. Health systems have the opportunity to drive behavior change through education. For example, how can education impact diabetes prevention? According to the CDC, roughly 37 million Americans live with diabetes today and a staggering 96 million have pre-diabetes. How can we prevent the 96 million with pre-diabetes from fully developing the condition? Access to and engagement with health education improves awareness, educates on early warning signs, and ultimately prevents escalation of serious health conditions.

    Health education will also continue to be used to improve health equity. No single educational format accommodates everyone—patients need an assortment of text, videos, illustrations, and interactive pieces. And the education must be available in multiple languages, depict diversity, and have the appropriate accessibility considerations.

    Lastly, patient education continues to be more personal and connected to technology, such as mobile phones, watches, and wearable devices. Education must meet the patient where they’re at and be available and optimized for digital channels.

    Don’t miss another Q&A—subscribe to AVIA Marketplace for updates.

    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Dr. Steve Kim of Voluware: A road map to the future of prior authorizations

    Q&A with Dr. Steve Kim of Voluware: A road map to the future of prior authorizations

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the prior authorization space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    With its end-to-end automation platform VALER, Voluware offers a unified solution for prior authorizations, referrals management, and eligibility and coverage. VALER fully automates prior authorization submissions and includes a comprehensive form library and real-time payer information and status monitoring. The cloud-based solution covers all service types, including professional, facility, technical, pharmacy, and DME authorization workflows, and creates a centralized communication hub to capture faxed medical necessity documentation and phone exchanges with payers.

    Co-founder and CEO Steve Kim, M.D., founded Voluware to solve issues related to highly manual prior authorization, referral, and eligibility workflows that he encountered during his time practicing pediatric surgery at Children’s Hospital Los Angeles. Dr. Kim formerly worked as an assistant professor at the University of Southern California Keck School of Medicine, where he also served as the director of clinical research informatics for CHLA. He received his undergraduate degree from Yale University, attended medical school at Cornell University Medical College, earned a Master of Science in Clinical Epidemiology from the University of Pennsylvania, and an MBA from the University of Southern California Marshall School of Business.

    Q: Can you tell us about your company and the challenges you are solving within the prior authorization space?

    A: Voluware was founded with a mission to ensure patients receive the care they need without unnecessary delays created by today’s manual administrative workflows. Our cloud-based platform, called VALER®, standardizes, streamlines and automates prior authorizations for health systems, hospitals, ambulatory clinics, and payers. Voluware’s workflow-centric and customized approach to each client’s unique prior authorization needs accelerates time to results and reduces barriers to access.

    Q: How does your company differentiate from other vendors in the same category?

    A: Voluware differentiates itself from other vendors in the prior authorization space with our understanding of both the deep technical complexities and the practical workflow realities that clients face in order to function in today’s evolving prior authorization environment. Our VALER platform was built from the ground up with not only the end user in mind, but also with the understanding that each authorization represents a patient waiting for care.

    VALER is the only solution in the market that robustly automates prior authorization submissions across all payers and service lines. While most other vendors primarily offer only authorization status verification across a few select payers for a few select services, VALER provides one source to comprehensively submit and verify authorizations across over 75 payer web portals with more than 1,000 payer fax forms.

    Our platform is not a one-size-fits-no-one approach to prior authorizations. We understand that each client brings its own unique mix of complex payer-specific requirements, inherent EHR limitations, and myriad workflows that aren’t necessarily compatible with a single approach. VALER tailored to each client’s broad organizational workflow needs in order to maximize workflow automation and eliminate manual and duplicative data entry wherever possible.

    VALER also rapidly adapts to changes in payer rules or requirements–a frequent occurrence, as anyone who has dealt with prior authorizations understands. In addition to the ability to centralize and maintain fragmented payer authorization workflows, VALER can quickly update and incorporate payer workflow changes at runtime, with no long waits for software upgrades or support tickets.

    Lastly, our clients enjoy unparalleled real-time visibility around prior authorizations. Over 80 percent of prior authorization workflows are completed manually, which means that it is virtually impossible to clearly grasp the root causes of bottlenecks and costly errors. But because prior authorizations are submitted and verified in VALER across all payers and service lines, clients have a clear view of every aspect of the prior authorization life cycle, from provider order to closed out prior authorization back in the EHR. We also provide real-time data and custom reporting on staff productivity, payer turnaround times and payer responses, along with detailed audit trails and activity logs.

    Q: What are some of the biggest changes your company has seen around how health systems are approaching prior authorization, given the changes in the landscape over the past couple of years?

    A: With over a decade of experience building prior authorization workflow automation solutions for patient access teams, the most significant changes that we’ve seen in how health systems are working to address prior authorizations have been the increased adoption of robotic processing automation (RPA) and labor offshoring/outsourcing. Each approach has its merits, but there are also significant issues that limit efficiency and effectiveness.

    With RPA/low code options for building automations, client teams can configure automations for highly standardized and repetitive tasks with good results. But the nature of prior authorizations is non-standardized, complex, and constantly changing, which is where problems arise. Configuring and maintaining these automations requires time, effort, and financial investment, and the complexity of these tasks can quickly consume client teams and negate any efficiency gains.

    With respect to outsourcing/offshoring as labor arbitrage, organizations can have difficulties understanding local payer rules, idiosyncrasies, and nuances when dealing with specific payer prior authorizations. That disconnect between providers and offshore patient access staff can inadvertently add delays and frustration to prior authorization workflows and erode or undermine the cost savings associated with labor arbitrage.

    VALER bypasses these issues and empowers existing patient access teams to do more. We eliminate unnecessary manual tasks and data entry and leverage staff experience, relationships, and knowledge.

    Q: What does an ideal client look like? How are health systems best organized for success in standing up prior authorization and adjacent capabilities?

    A: The ideal VALER client doesn’t necessarily fit with a specific structural mold. Our most successful clients are organizations that follow a few general principles in their preparation and approach to implementation:

    1. Understand what current prior authorization workflows look like across the organization. Prior authorization workflows are incredibly fragmented and highly variable in nature. We frequently find significant variation in how prior authorizations are processed, not only from team to team, but also between individual staff members. This often reflects a lack of standardization, transparency, and education when it comes to payer-specific authorization requirements. Organizations should identify best practices and move to standardization. Ideally they take the time to develop process maps and create clear roles and responsibilities, which can decrease friction and build accountability.
    2. Understand the time, effort, and cost involved with prior authorizations in order to prioritize efforts. Identifying overall costs for managing prior authorizations across various service areas can help organizations gain a clear understanding of where to start and how to maximize ROI and minimize time to value. While measuring this burden, organizations should consider the operational staff time and costs that the prior authorization process incurs and the denied dollars attributable to prior authorization errors.
    3. Create a clear roadmap for transforming prior authorizations. Working to define a clear roadmap for implementation has been a hallmark for success with VALER clients. Frequently, we would start VALER with centralized patient access teams with a high volume of prior authorization submissions and verifications–we typically see this in health systems with a centralized team that handles high volume diagnostic imaging and/or surgery/procedure authorizations. In our experience, looking at areas of high impact first and establishing early wins with automation leads to increased engagement and user adoption across other teams.
    4. Do your homework–listen to your staff to get their input and buy-in. Listening closely to key staff members who actually work on securing prior authorizations is critical to successful implementation. We’ve seen many prior authorization solutions that apply new technology (AI, machine learning, or RPA) to the problem with no meaningful understanding of the practical workflow implications involved. Organizations that take the time to vet solutions and invite the feedback of frontline staff are much better positioned to understand the opportunities and limitations of technology. Involving user input better aligns expectations and fosters engagement that can better drive meaningful adoption and results.

    Our most successful clients are the ones that thoughtfully approach problems, identify opportunities, and develop clear plans with VALER. The Voluware team can also lend its expertise to assist organizations with successful planning and implementation.

    Q: What measurable outcomes have you seen from your clients?

    A: VALER clients have seen many benefits related to their prior authorization workflows. The team at Oregon Health & Sciences University (OHSU) reported the following results with VALER for their central patient access team’s prior authorization workflows:

    • Staff spent 45 percent less time processing prior authorizations (including submission, verification, and pushing back to the EHR)
    • Overall authorization volume increased 11 percent with the same or smaller staff
    • Authorization days out metric increased from 5 to 13 days, with fewer cancellations and reschedules

    Other VALER clients have similarly experienced a 40-50 percent reduction in overall prior authorization staff processing times, doubling of staff productivity, and higher satisfaction with prior authorization workflows.

    With respect to denials related to prior authorizations, an academic medical center client reported a reduction in first pass denial rates of more than 50 percent within the first year of utilizing VALER.

    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of automation generally?

    A: VALER has developed and is currently implementing a pilot with a major national health plan for application programming interfaces (APIs) to provide the following real-time prior authorization functionalities:

    • Pre-check to determine PA requirements for medical, radiological, DME, Part B drugs and home health care services
    • Electronic submission of PA requests directly to payer
    • Auto-approve requests when available from payer
    • Electronic notification and information about authorization adjudication
    • Eligibility verification
    • Referral status checking (if required for authorization)
    Q: How is your company partnering with clients as reimbursements and use cases shift?

    A: At Voluware, we pride ourselves on being good partners with our provider client teams that work on the frontlines. Our VALER platform has always been custom designed with client team workflows in mind, with runtime-changeable architecture that continuously adapts and evolves to meet new use cases with respect to payer authorization requirements and workflow changes. In this way, we provide clients with a flexible system to keep pace with an ever-changing reimbursement environment.

    Q: What are the biggest opportunities health systems should be thinking about this year when it comes to automation?

    A: Health systems are facing staffing shortages in the administrative ranks as a result of the pandemic and the subsequent “Great Resignation,” which means that health systems need to focus on targeted automation opportunities with the highest return on investment. Prior authorization submission and verification workflows are a high-value opportunity for workflow automation with significant operational impact for depleted patient access teams, with the added benefit of fewer costly downstream denials and avoidable write-offs. When health systems invest in the right technology platforms to support automated prior authorizations, they can empower staff to improve productivity, address key bottlenecks to patient access, and mitigate lost revenue.

    Q: How do you see the prior authorization space evolving in the next two to five years and beyond?

    A: Healthcare organizations will continue to advocate for CMS regulations that require payers to transition from antiquated workflows to electronic prior authorizations with more automation. We can already see this momentum with proposed CMS rule changes regarding prior authorization and federal and state legislative efforts to improve standardization, transparency, and accountability. Greater regulatory scrutiny will target not only health plans, but certified EHRs as well in order to promote interoperability and facilitate electronic exchange and adjudication between payers with application programming interfaces (APIs). Compliance will take time and significant labor and investment for both payers and providers to achieve real-time request and adjudication of prior authorizations.

    Today, VALER provides a bootstrapped authorization clearinghouse that already allows for electronic exchange and meaningful automation of existing manual workflows. Meanwhile, we’re hard at work building a roadmap for the future of real-time APIs for all prior authorizations across all payers.

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    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Steve Giannini of Bright.md: Entering the Telehealth 2.0 Era

    Q&A with Steve Giannini of Bright.md: Entering the Telehealth 2.0 Era

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the virtual visits space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Bright.md’s asynchronous telehealth solution focuses specifically on low-acuity care, which drives down costs and increases provider capacity for higher-acuity patients. The Navigate solution captures symptoms and instantly guides patients to the appropriate level of care within the health system, with pathways that can be adjusted based on the time or chief complaint. The Interview offering utilizes a library of evidence-based clinical interviews to support diagnosis, with automated documentation and interoperable chart-ready SOAP notes. Providers can utilize the Treat solution to treat more than 140 low-acuity conditions in as little as two minutes, with instant diagnosis, prescriptions, and referrals.

    Chief Executive Officer Steve Giannini’s career has spanned over two decades in business growth, operations, and development in the software, technology, and healthcare industries. As a member of CNET’s leadership team, he focused on strategic partnerships and business development, which eventually inspired him to co-found Alliance, a San Francisco-based business accelerator. Prior to joining Bright.md, Steve co-founded the Portland-based software company Opal.

    Q: Can you tell us about your company and the challenges you are solving within the virtual visit space?

    Many health systems are struggling with staff and provider shortages and financial constraints. These shortages and limited resources are leading to greater patient access problems (long wait times) and clinical staff burnout. Meanwhile, a large number of patients have low-acuity needs that often don’t require a face-to-face visit.

    The typical Bright.md customer is looking for a solution to help “right-size” care delivery workflows, direct patients to the appropriate venue of care, improve the patient experience, and reduce the administrative burden on staff and providers. Bright.md’s asynchronous telehealth solution can help alleviate the access strain on clinics, provide convenient care that patients are looking for, and allow flexibility for providers to deliver care with greater efficiency and less administrative burden.

    Our solution lets providers treat low-acuity conditions virtually, without a real-time interaction—all while driving patient satisfaction and quality outcomes. Consisting of evidence-based, self-service clinical interviews designed to treat more than 130 conditions, patients answer questions about their symptoms and medical history and upload photos when necessary. Clinical decision support serves the provider with a recommended diagnosis and treatment plan that they can simply confirm or modify based on their own clinical judgment. Bright.md automates the documentation process with a chart note in SOAP format that is fully integrated with the EHR encounter, resulting in only about two minutes of provider time per patient.

    Q: How does your company differentiate from other virtual visit vendors?

    A: Most virtual visit solutions don’t even come close to unlocking asynchronous care’s full potential as a tool for quality, cost-effective, and clinically efficient care. In contrast, Bright.md offers:

    • Expansive proprietary clinical content: We offer 30 unique patient interviews, with clinical decision support that aids providers in treating more than 130 diagnoses. Our interviews are developed and maintained by a team of board-certified physicians.
    • Bi-directional EHR integration(Epic, Cerner, athenahealth) means that asynchronous care isn’t just an add-on, but an integral part of care delivery workflows.
    • Automated documentation drastically reduces the administrative work required by clinicians. Bright.md includes SOAP-formatted chart notes, after-visit summaries, prescription orders, and billing.
    • Self-service configurability, ease of use, and our in-depth reporting and analytics make it easy for systems to develop an asynchronous care program that fits their unique needs.
    Q: What are some of the biggest changes your company has seen around how health systems are approaching virtual visits, given the changes in the landscape over the past couple of years?

    A: As a result of the pandemic, many health systems stood up video visits as quickly as possible to accommodate quarantine requirements. Video visits were great to solve immediate problems, but are not set up to solve today’s challenges around staffing shortages, workflow inefficiencies, and patient access.

    Now that systems are able to look at their long-term hybrid care strategies and not just the immediate response to the pandemic, they are looking for integrated virtual capabilities that overhaul their processes for more efficient providers; less administrative work; and easier access for patients.

    Q: What does an ideal client look like? How are health systems best organized for success in standing up virtual visit capabilities?

    Our ideal client profile includes large health systems in the U.S. that employ at least 1,000 physicians, operate urgent care centers within their systems, and use Epic, Cerner, or athenahealth as their EHRs.

    Our most successful customers have a centralized staffing model in which advanced practitioners provide care through multiple virtual care modalities, such as video, chat, asynchronous, and so on. This allows them to provide care quickly and efficiently. In addition to staffing, our clients who offer asynchronous visits at lower costs see the most volume and success. Systems who can negotiate with payers to offer a $0 service drive the highest volume, and those who charge patients $20 to 30 out-of-pocket per asynchronous visit–the cost of a typical co-pay–see high volumes as well.

    Q: What measurable outcomes have you seen from your clients?

    A: Clients who choose Bright.md as their asynchronous care solution see a number of benefits related to clinical efficiency and patient and provider satisfaction, including:

    • Two minutes of provider time to deliver care asynchronously, which leads to significant clinician cost savings, frees up additional capacity, and addresses staffing challenges.
    • 97 percent patient satisfaction rate. Our solution attracts new patients to help capture downstream revenue and drives patient retention and loyalty.
    • 90 percent provider satisfaction rate. Bright.md improves provider experience and retention, and reduces provider burnout.
    • 35 percent of patients who have used Bright.md avoided the ED or urgent care, which reduces unnecessary traffic in these venues, improves patient access, and lowers overall costs to deliver care. 
    • 13 percent of asynchronous visits are completed by net new patients to the system–our solution drives downstream revenue.
    • 89 percent of Bright.md patients did not seek follow-up care within 30 days for the same condition (compared to 76 percent of primary care office visits benchmark). This highlights the clinical quality of Bright.md’s asynchronous care and its ability to deliver treatment that replaces unnecessary in-person visits.
    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of virtual visits?

    A: At Bright.md, we believe that asynchronous care can add value to every clinical interaction. With that said, our product strategy consists of three pillars that drive our innovation:

    • Delight patients with easy, accessible care through ongoing improvements to reduce friction and boost satisfaction, including user experience enhancements.
    • Empower providers with asynchronous tools they love by continuing to drive efficiency and usability for providers, embedding their experience in Epic through hyperdrive and In Basket notifications, delivering a new e-prescribing experience, building a custom formulary for more clinical autonomy, and more.
    • Put asynchronous care into more hands, by expanding usage of asynchronous care with new clinical content for chronic conditions, perioperative care and travel medicine, in addition to integrated workflows for acquiring new patients.
    Q: How is your company partnering with clients as reimbursements and use cases shift?

    A: While reimbursement policy for asynchronous telehealth continues to shift on a state-by-state basis, we partner with our customers to equip them with the right data, clinical quality metrics, and more to bring to negotiations with payers to make the case for equal reimbursements. In 2022, we also released new capabilities around how we onboard patients to unique billing paths, as many of our customers want to serve different populations with different costs. For example, many systems want to offer Bright.md visits at $0 for their at-risk contracts for maximum cost savings, while they may want to offer $25 cash pay for the general population.

    As for evolving use cases, we are gaining more interest in the role of asynchronous visits for chronic care management, including hypertension and post-operative care. Each quarter, we meet with our clinical advisory board, which is composed of clinical leadership at our client sites, to discuss new and evolving use cases of our product.

    Q: What are the biggest opportunities health systems should be thinking about this coming year when it comes to virtual visits?

    A: We’ve entered into a promising “Telehealth 2.0” era. The healthcare industry is shifting away from thinking about digital health tools and telehealth that merely replicate the in-person experience, and looking instead to the tools and solutions that transform care delivery.

    As health systems continue to hone their strategy this year, video visits and traditional virtual visits that don’t solve capacity challenges or integrate into existing workflows need to change. More health systems should continue to explore asynchronous, remote patient monitoring, digital tools for chronic disease management, and other opportunities for virtual visits. This movement will help us maintain critical momentum as we continue to move toward a care delivery system that can not only get us out of our current crisis, but set us up for longer-term strategic growth.

    Q: How do you see virtual visits evolving in 2023 and beyond?

    A: Five years from now, we’ll see virtual visits as not only another modality of care, but a truly integral part of a hybrid care model that is better for patients, providers, and healthcare’s bottom line. We’ve only begun to tap into the potential for asynchronous telehealth to address challenges like capacity constraints, patient access and health equity issues, and workforce shortages.

    As asynchronous care expands to become more widely available, understood, and used in the coming years, we’ll see it leveraged to make every single clinical interaction more productive and enjoyable for patients and providers. We’ll see things like automated pre-visit intake so that providers can spend time building relationships with their patients, asynchronous annual wellness visits, remote asynchronous perioperative care, and so much more.

    At Bright.md, we’re excited to continue working with health systems and other digital health companies to power a healthier future with asynchronous care, and to make high-quality care more accessible, affordable, and convenient for everyone.

    Don’t miss another Q&A—subscribe to AVIA Marketplace for updates.

    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • Q&A with Ethan Otterlei of Zipnosis: Unlocking the potential of asynchronous care

    Q&A with Ethan Otterlei of Zipnosis: Unlocking the potential of asynchronous care

    AVIA Marketplace is the leading online resource for accurate, unbiased information about digital health companies and solutions. Our goal: To empower hospitals and health systems with the information they need to match with vendors who can meet their unique needs. We asked the top companies in the virtual visits space about their solutions and what they think the future of digital health looks like. No sponsored content or advertorials—just transparency and insights that decision-makers can use. 

    Zipnosis aims to improve the virtual care experience for both patients and providers with a flexible platform that automates administrative tasks and reduces clinical work time to an average of 89 seconds per encounter. With both synchronous and asynchronous virtual visit capabilities, Zipnosis walks patients through virtual triage and automatically pre-populates the platform with relevant data to reduce the need for manual documentation. Care teams can access a wide array of clinical protocols within the platform, and custom workflows are available to meet the needs of a variety of service lines.

    Associate Vice President of Partner Sales Ethan Otterlei is a healthcare product expert with 20 years of experience in software-based companies. In his leadership role at Zipnosis, Ethan cultivates unique partnerships and leverages his deep knowledge of the platform and health system buying practices to facilitate a smooth and efficient sales process. A software engineer by training, Ethan holds a degree in computer science from the University of Minnesota.

    Q: Can you tell us about your company and the challenges you are solving within the virtual visit space?

    A: We are building healthcare for today’s consumers and tomorrow’s dynamic health organizations by prioritizing the only two people who matter in healthcare: patients and providers. Our approach is to enable traditional care models with an adaptive telemedicine solution that reduces costs, improves outcomes and creates happier patients.

    Zipnosis is the technology at the heart of our solution and is ideal for enterprise health systems and clinics. Our virtual care platform increases patient access while decreasing provider work time by about 99 percent. Zipnosis leverages asynchronous medical protocols to help providers deliver care in under two minutes in most cases, which allows them to treat more patients while spending more time with the patients who need it most.

    Healthcare’s Marketplace is a provider network that onloads and offloads patient demand based on each organization’s unique goals. Healthcare’s Marketplace allows organizations to choose how they utilize network resources, which are available around the clock, 365 days a year. Providers can use the network to:  

    • Outsource low acuity visits to the marketplace 
    • Leverage internal capacity across their organizations to meet internal and external patient demand 
    • Divert to marketplace providers during high demand or after hours 
    Q: How does your company differentiate from other virtual visit vendors?

    A: Our asynchronous solution allows providers to treat more than 400 unique diagnoses in just 89 seconds per visit. That’s twice as fast as other asynchronous platforms, with about three times as many unique diagnoses. With more than four million encounters so far,  provider efficiency with Zipnosis outpaces the competition. We can deliver these quick diagnoses because of our charting accuracy and clinical adherence that exceeds in-person care or what other virtual visit vendors can provide. Our platform automatically triages patients and escalates them to other modalities native to Zipnosis (chat, phone, or video) and routes to in-person care whenever necessary–something that other asynchronous platforms don’t support.

    Q: What are some of the biggest changes your company has seen around how health systems are approaching virtual visits, given the changes in the landscape over the past couple of years?

    A: Hospitals, health systems, and provider groups across the nation are feeling the strain of staffing shortages and provider burnout. Meanwhile, patient leakage is rising as patients prioritize convenience and access to care over human interaction.

    Our asynchronous solution prioritizes the patient and healthcare provider experience to reduce physician burnout while increasing patient satisfaction. Zipnosis clients see enormous capacity increases–about 60 percent per provider–just by finding small pockets of time during each day. Directing low-acuity cases to asynchronous visits helps physicians maintain RVUs and increase revenue while making it easier to prioritize patients in need of synchronous care, including in-person visits.

    Q: What does an ideal client look like? How are health systems best organized for success in standing up virtual visit capabilities?

    A: We don’t just sell technology–we partner with forward-thinking leaders in clinical, healthcare marketing, innovation and transformation who want to step outside the confines of traditional healthcare and find real solutions to real challenges. Physicians and patients consistently appreciate the Zipnosis user experience, and their enthusiasm makes onboarding much easier, but we also handle patient support through Zendesk and a toll-free support line.

    Going live simply requires our partners to make the platform easy for patients to access. Our success and implementation teams offer a standardized launch process that includes working with marketing stakeholders to prioritize digital on-ramps and marketing communications.

    An ideal and successful client is one that is looking to fulfill the quintuple aim of healthcare transformation:

    • Reduce patient costs
    • Improve the health of populations
    • Improve the patient experience
    • Achieve health equity
    • Promote physician and staff well-being

    Because Zipnosis integrates with existing EMRs, there are no technological or organizational requirements for success other than a desire to solve the big healthcare challenges within their own systems.

    Q: What impact have you seen from your clients who have prioritized virtual visits?

    A: With four million encounters under our belt, we’ve conducted numerous case studies and found that Zipnosis:

    • Reduces physician work time to 89 seconds per visit 
    • Automates 99 percent of administrative duties 
    • Increases provider capacity by 60% in just 15 minutes a day 
    •  Reduces low-acuity visit workload so providers can spend more time with higher-need patients

     

    Additionally, we’ve found that about 40 percent of Zipnosis visits are new visits for our clients, and these new patients are 276 percent more likely to convert to health system patients. Each of these new patients brings in an average of $2,900 of revenue in their first year. To dive deeper into this data, see our new Asynchronous Telemedicine Guide.

    Q: What major functional enhancements and/or product investments are you making in the near term to keep up with the evolution of virtual visits?

    A: We’re always working to expand our library of asynchronous protocols as a component of our mission to expand health equity and make it easier for all people to access high quality healthcare. One key component of health equity is overcoming language barriers, so we’re excited to announce that the Zipnosis asynchronous platform is now available in Spanish to support the largest non-English-speaking population in the U.S. Our dynamic content management system provides Spanish translations of all patient-facing text, care plans, and patient education while translating patient inputs into English to allow easy communication with providers. 

    We also recently launched Healthcare’s Marketplace, one of our latest initiatives to connect patient demand with provider capacity. This revolutionary provider network onloads and offloads patient demand based on each organization’s unique goals, and is available in all 50 states, 24 hours a day, seven days a week, 365 days per year.

    Q: How is your company partnering with clients as reimbursements and use cases shift?

    A: Flexible payment options are a priority for us–we offer a cash pay experience as well as eligibility checks and support for existing revenue cycle management workflows. Zipnosis also supports special use cases, such as free care as an employee benefit. Even in states that are less supportive of telemedicine reimbursement, the workflows and efficiencies the Zipnosis platform offers make it financially favorable while creating more time for patients who need higher acuity or in-person care.

    Q: What are the biggest opportunities health systems should be thinking about this coming year when it comes to virtual visits?

    A: Asynchronous telemedicine is likely the most valuable and underutilized tool in healthcare, and it should be on your roadmap whether your organization is concerned about losing market share, keeping up with patient demand, tapping unused capacity, reducing physician burnout, expanding access to care, or driving overall revenue. As more organizations realize what we’ve been saying for the last 15 years–that asynchronous telemedicine is key to solving healthcare’s greatest challenges–health systems and clinics should consider whether they want to keep up with the shift toward asynchronous care or risk struggling to catch up later.

    Q: How do you see virtual visits evolving in 2023 and beyond?

    A: Healthcare staffing shortages are likely to worsen over the next few years, so health systems, provider groups, and urgent care centers must adopt approaches to treat patients more efficiently. Asynchronous telemedicine is the ideal solution, and we expect asynchronous modes of care to become more prevalent. While asynchronous telemedicine isn’t new technology, larger companies like Amazon are finally realizing its potential. It will become increasingly important to adopt innovative virtual and hybrid care strategies. Reluctant organizations will be left behind as their competitors reap the benefits.

    Don’t miss another Q&A—subscribe to AVIA Marketplace for updates.

    AVIA Marketplace helps hospitals and health systems make informed decisions about digital health companies and solutions. With the vast library of accurate, unbiased information available in AVIA Marketplace, providers can search and compare vendors, review Match Scores, and identify the companies and products that fit their unique needs.

  • How to get hospitals and health systems to attend your webinar

    How to get hospitals and health systems to attend your webinar

    A webinar takes a substantial amount of time to create and organize, and you want to maximize attendance. Where do you start? There are a variety of tools and strategies to get your name out in the healthcare industry and boost attendees. With the current market, many professional industries are going virtual, giving you more opportunities than ever. Let’s breakdown how you can increase your visibility and attendance.

    Marketing

    As with most fields, getting your name out there will be one of the largest components of your business. You want to ensure you put your energy towards the most effective strategies. Since virtual communication is often the best way to reach a large audience, have a solid marketing process in place.  Going digital can decrease your costs and increase your visibility. A few top strategies are:

    Use social media

    Highlight any upcoming webinars or courses on your social media accounts, like Twitter, LinkedIn, or Facebook. On many of these you can create an event to keep a tally of any interest and engage with potential attendees. Using hashtags can also increase the likelihood your post will be seen.

    E-mails

    Email marketing can help you drive registrations up by 57%, so you want to maximize this as much as possible! E-mails can help drive industry professionals to your content, offers, and webinars. Customizing your e-mails may be more effective but will also be more time-consuming. Once they sign up, make sure to send them a link and a thank you.

    Newsletters

    If you have an e-mail system already in place to reach out to your clients, include any upcoming webinars and events on them clearly. If you don’t have a newsletter yet, create a simple one that can go to any existing or potential clients. You can include information about the industry as a whole and events. Make sure you link it back to your website or blogs to boost traffic. Make it easy to sign up for your webinar with one-click.

    Use your website

    Post your webinars plainly on your website and try to drive continual traffic there. Some ways you can do this are to use keywords or Search Engine Optimization (SEO). Adding a blog can be helpful for boosting views and letting buyers find you. It can also add excellent credibility, as you can professionally speak on the topic in depth.

    Add an option to Add-to Calendar

    You can include an RSVP in your e-mails or on your website that can easily transfer over to someone’s professional calendar, like Outlook or Gmail. This is a great option that not only reminds them of the upcoming webinar but can help you keep track of attendance. This may take some light coding, but generally it is simple to include in your marketing and digital ads.

    Use a call-to-action

    A call-to-action, otherwise known as a CTA, is a consistent way to draw people from the healthcare industry to your webinars. A CTA gives the reader or buyer a sense of urgency and enforces how your webinar is valuable. It is typically a few sentences that will link the buyer or attendee to your webinar information. Most people find these are most effective when placed at the end of a blog, in a newsletter, or in a social media post. A few examples of CTA’s include:

    • Sign up for our webinar now and receive 50% off!
    • Limited time offer, register here!
    • Learn more about the future of healthcare today!
    • Want to see cost effective strategies for your hospital? Click here to learn more!

    Calls-to-action are appealing to your ideal buyer and use an incentive to encourage them to sign up for your webinar. This could be targeted toward their knowledge of the industry, saving money, meeting continuing education credits, or anything that you feel grabs their attention. Include a hyperlink on a keyword (like here, register, sign up) for a one-click easy sign-up for them to see your webinar information.

    Promotions and incentives

    While getting the word out is a critical component to increasing your attendance, you also need to incentivize the professionals seeing your advertisements or information. How would they benefit from attending your webinar? What information will they walk away with? Include any promotions or special offers. It may help to include a deadline to the offers- such as purchasing within the next 48 hours to save 50%.

    If you want to target specific companies or hospital systems, get in touch with their administrators or whatever contact can help you get the news out. You may be able to get your information listed on an e-mail with your offer. This can be particularly helpful for nurses or doctors, who may need certain credits or courses to meet their medical license requirements. If you have another upcoming webinar, offer your attendee’s a special bonus offer to attend that.

    In-person connections

    Having great face-to-face connections can help you build your attendee’s and trust among those who work in healthcare. If you are starting out fresh, attend webinars or in-person events to network among others. You can also reach out to those offering events and ask to present your material. When networking, collect information on who is attending. Do attendees work in a hospital? Tell them how your webinar can help them save money or offer information about digital health technologies. Don’t underestimate the power of networking!

    Getting feedback

    Follow-up on those who have attended your webinars to see what you can do to increase participation. It may be as simple as a small time adjustment, or possibly changing the time to a common lunch break hour. This can also help you streamline your content to what the industry is looking for or needs. 

    Need help creating a successful webinar? AVIA Marketplace can help! We help buyers and customers find YOU. Our platform gives you a great foundation for awareness, company information, and building a customer base.


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