This report uses the CB Insights Execution & Market Strength Positioning (ESP) Matrix to analyze vendors that deliver electronic prior authorization for healthcare providers.
Why is electronic prior authorization so critical?
- Prior authorizations have been an effective tool for health plans working to control medical costs, but have become an administrative challenge for providers. A 2020 CAQH industry report names prior authorizations as the most expensive administrative process for providers.
- Electronic prior authorization software helps automate and accelerate prior authorization determinations, submissions, and status checking.
What key outcomes do electronic prior authorization solutions drive?
- Reduction in time spent on prior authorization administrative tasks
- Improvements to front office staff productivity
- Fewer delays to patient care due to prior authorization requirements
- Lower cost per authorization
- Reduction in auth-related denials
Free Download: the State of healthcare
Healthcare startups saw a record-breaking 1,904 deals in Q3’21. Get our full report to find out all the trends.
Who are the electronic prior authorization vendors?
Given the rising administrative challenges associated with prior authorizations, providers are increasingly looking to technology vendors to help them manage these efforts.
We surveyed the players in this space and have mapped the leading players using our ESP research methodology into 1 of 4 categories: Leaders, Outperformers, Highfliers, and Challengers.
The technology vendors that are ultimately featured in this ESP Vendor Assessment include:
What companies are adopting electronic prior authorization solutions?
In this ESP Vendor Assessment, we look at which companies have adopted electronic prior authorization solutions and mention organizations including:
- Cleveland Clinic
- Mayo Clinic
- Strategic Radiology
- WVU Medicine
- Yuma Regional Medical Center
What roles or functions are buying electronic prior authorization solutions?
In our discussions with electronic prior authorization solutions vendors and buyers, decisions and influence for these decisions often reside with the below functions or businesses and with these specific titles:
- Health systems — chief medical officer, chief medical informatics officer, chief finance officer, chief marketing officer, VP of innovation
- Health insurers — chief technology officer, chief information officer, chief medical officer, chief innovation officer, chief strategy officer, chief marketing officer
- Specialty care settings — Director/VP of patient access at specialty pharmacies, infusion centers, genomic testing centers, medical imaging centers
Want to dig deeper into the electronic prior authorization market?
CB Insights clients can download the entire 43-page ESP report using the sidebar to see our full analysis of this technology market.
The full report includes discussion of:
- Market need & traction
- Market stats & data
- Rich company profiles
- Insights into customer/peer adoption
If you are looking to understand the electronic prior authorization vendor landscape, readying your org for an RFP, or initiating any type of vendor selection process, download this ESP Vendor Assessment.