What You Should Know: – Boston-based health IT company Cohere Health has closed a $36 million Series B funding round led by Polaris Partners, with additional participation from new investors Longitude Capital and Deerfield Management, as well as existing investors Flare Capital Partners and Define Ventures. The round comes less than a… Read More »Cohere Health Raises $36M to Automate Prior Authorization Between Payers & Providers
Cohere Health raised $36 million in a Series B funding round less than two years after its inception. It will use the new funds to expand its prior authorization platform and integrate health plan benefits to eliminate missed opportunities for care.
Playing Poker With the Devil: “Prior Authorizations” are Paralyzing Patients and Burning out Providers
By HANS DUVEFELT The faxes keep coming in, sometimes several at a time. “Your (Medicare) patient has received a temporary supply, but the drug you prescribed is not on our formulary or the dose is exceeding our limits.” Well, which is it? Nine times out of… Read More »Playing Poker With the Devil: “Prior Authorizations” are Paralyzing Patients and Burning out Providers
Prior authorization is a massive and growing problem for patients and providers, and regulation is not likely to solve it completely or anytime soon.
What You Should Know: – Each year, the US healthcare industry spends $39 billion on 9 administrative transactions, according to a new report from CAQH. – The 2020 CAQH Index also uncovered that by automating these transactions, the industry could save $16.3 billion annually–a 42%… Read More »Healthcare Can Save $16.3B Automating Administrative Transactions, Report Finds
Giri Rajaiah, Executive Leader, Vice President, Healthcare & Life Sciences, DISYS As the saying goes, necessity is the mother of invention. A similar correlation is seen in the quest to leverage innovation and out-of-the-box thinking to address key problems facing the healthcare industry. The ongoing… Read More »How Automation is Key to the Future of Healthcare Operations
What You Should Know: – On the heels of $225.5 million dollars in funding and a $1.5B valuation this week, Olive today announced its acquisition of Verata Health to create a combined AI prior authorization solution for providers and payers under the Olive name. –… Read More »M&A: Olive Acquires AI Prior Authorization Company Verata Health
What You Should Know: – Cohere Health partners with health insurer Humana to modernize the prior authorization process for musculoskeletal treatment across 12 states. – In addition, the company has closed an additional $10M in funding led by Flare Capital Partners and Define Venture, bringing… Read More »Humana Taps Cohere Health to Modernize Prior Authorizations for Musculoskeletal Treatment
Prior authorization is a requirement that health plans require physicians to obtain plan approval in order to prescribe a patient a given medication. Prior authorizations may be put in place to insure medications are not used inappropriately or for payers to try to reduce cost.… Read More »The problem with prior authorization
What You Should Know: – Revenue cycle management provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue cycle management, workflow automation, and data analytics tools at a $1.3B valuation. – The acquisition will create the first unified healthcare payments platform with both commercial… Read More »Waystar Acquires Medicare RCM Company eSolutions at $1.3B Valuation
As the COVID-19 pandemic continues to change healthcare operations in the world, foundational systems are being adapted to meet these new demands. Sometimes it takes extreme circumstances to see the cracks in a system. COVID-19 has exposed areas with more room for improvement in the… Read More »How Times of Crisis Spur Needed Change in Healthcare Delivery
What You Should Know: – Boston-based health IT start-up Cohere Health announced the official launch of its company with a $10 million Series A funding round led by Flare Capital Partners. – The company’s patient journey-focused platform improves the notoriously difficult prior authorization process and… Read More »Cohere Health Launches with $10M to Increase Transparency Across Care Journey
With public and private healthcare spending significantly outpacing that of other countries, U.S. hospitals face intense pressure to find new ways to capture greater value. More and more, organizations are finding that partnerships with existing vendors can help unlock next-level performance gains in a transformative… Read More »4 Ways Healthcare Organizations Can Establish Partnerships to Drive Innovation