The Centers for Medicare & Medicaid Services has ambitious plans to improve the prior authorization process between providers and payers – and to save $15 billion over 10 years in the process.
The tools it envisions using in its efforts include digitization, better data exchange, and streamlined prior authorization processes.
It also will seek to foster greater transparency, requiring payers to be clearer about their policies and guidelines and to provide better explanations when they deny requests for care.
Doing so, CMS believes, will reduce health care costs by $15 billion over ten years.
Learn more about CMS’s prior authorization goals and how it envisions achieving them from the Becker’s Hospital Review article “How CMS is digitizing prior authorizations to save $15B.”