Infographic: Understanding Prior Authorizations

Friday, May 31st, 2019
This post was written by Melanie Matthews

Designed as a safety and cost-savings measure, prior authorizations by health insurance companies determine if they will cover a prescribed procedure, service or medication. While the process is intended for safety and cost-savings, they can delay patient treatment and lead to negative patient outcomes, according to a new infographic by Infinx.

The infographic looks at why prior authorizations are needed as well as their impact on patients, providers and the healthcare industry in general.

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS SuccessA laser focus on population health interventions and processes can generate immediate revenue streams for fledgling accountable care organizations that support the hard work of creating a sustainable ACO business model. This population health priority has proven a lucrative strategy for Caravan Health, whose 23 ACO clients saved more than $26 million across approximately 250,000 covered lives in 2016 under the Medicare Shared Savings Program (MSSP).

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success examines Caravan Health’s population health-focused approach for ACOs and its potential for positioning ACOs for success under MSSP and MACRA’s Merit-based Incentive Payment System (MIPS).

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