BOSTON, Oct. 22, 2020 /PRNewswire/ -- Cohere Health,
a healthcare collaboration technology company, announced today an
agreement with Humana Inc. (NYSE: HUM) to improve the prior
authorization process for musculoskeletal treatment across 12
states, starting Jan. 1, 2021. Cohere
aligns physicians, patients and health plans on a patient's optimal
healthcare experience—enabling access to higher quality care while
at the same time minimizing administrative burden and siloed
decision-making.
The partnership leverages CohereNext Platform's prior
authorization capability which grants authorizations across an
entire episode of care, in effect pre-authorizing a complete
treatment regimen from initial diagnosis to treatment plan
selection, and, ultimately, to the patient's return to good health.
Cohere's approach aims to expedite evidence-based treatment plans
to improve the healthcare experience for doctors and patients
alike.
Humana will employ the CohereNext Platform to streamline
prior authorizations in musculoskeletal treatment in Alabama, Georgia, Indiana, Kentucky, Michigan, North
Carolina, Ohio,
Pennsylvania, South Carolina, Tennessee, Virginia and West
Virginia. The platform will initially serve approximately 2
million members and more than 3,500 physician practices.
"Through this strategic initiative and collaboration with Cohere
Health, Humana is building on its commitment to reduce the
complexity and friction of prior authorization for our physicians
and members," said William Shrank, MD, MSHS, Chief Medical Officer,
Humana and Board Member, Cohere Health. "Cohere's solution was
co-designed with physicians and represents a major leap forward in
improved physician experience and the adoption of evidence-based
medicine."
This partnership supports Humana's vision to reimagine and
modernize processes for prior authorization by reducing approval
times and improving delivery of care, all while preserving
important benefits such as safety, predictability and cost
containment.
Cohere's solution will initially focus on prior authorization;
the company is developing additional use cases such as value-based
contract performance, improving physician and patient engagement,
and optimizing health plan clinical programs. By facilitating
physician and health plan collaboration, Cohere's technology will
help accelerate the evolution to value-based care models.
"We are pleased to partner with an industry leader and innovator
like Humana to reduce the administrative burden on physicians and
improve clinical outcomes for its members. Physician and patient
transparency is the cornerstone of our approach," said Siva
Namasivayam, CEO, Cohere Health. "Cohere Health is focused on
simplifying healthcare's status quo by addressing barriers to
experience, quality and cost. Our platform and solutions are
developed with the latest design thinking and technologies with
physician and patient-centric perspectives that acknowledges the
realities of the variations in individualized care journeys."
The CohereNext Platform improves the physician experience
and quality by:
- Authorizations that begin with diagnoses and not billing
codes
- Facilitating and auto-approving evidence-based treatment
plans
- Delivering a peer review process with a true peer specialist or
sub-specialist
- Sharing quality performance relative to peers for specific care
paths and patient cohorts
- Providing tools, data and technology that optimizes value-based
payment
About Cohere Health
Cohere Health moves quality care
forward. Cohere's digital
healthcare collaboration platform and supporting
services align patients, physicians and health plans at the point
of diagnosis to expedite physician-approved, evidence-based
treatment plans. With the goal of creating optimal care journeys
for every patient, Cohere is transforming legacy processes to more
quickly achieve the goal of higher quality care and lower cost for
all. Cohere works with physicians and health plans committed to the
transparent delivery of quality patient care. Cohere's investors
include Flare Capital Partners and Define Ventures. For more
information, visit https://coherehealth.com.
About Humana
Humana Inc. is committed to helping our
millions of medical and specialty members achieve their best
health. Our successful history in care delivery and health plan
administration is helping us create a new kind of integrated care
with the power to improve health and well-being and lower costs.
Our efforts are leading to a better quality of life for people with
Medicare, families, individuals, military service personnel, and
communities at large.
To accomplish that, we support physicians and other health care
professionals as they work to deliver the right care in the right
place for their patients, our members. Our range of clinical
capabilities, resources and tools – such as in-home care,
behavioral health, pharmacy services, data analytics and wellness
solutions – combine to produce a simplified experience that makes
health care easier to navigate and more effective.
More information regarding Humana is available to investors via
the Investor Relations page of the company's web site at
www.humana.com, including copies of:
- Annual reports to stockholders
- Securities and Exchange Commission filings
- Most recent investor conference presentations
- Quarterly earnings news releases and conference calls
- Calendar of events
- Corporate Governance information
Media Contact:
Christopher
Currington
Amendola Communications for Cohere Health
314.799.1987
ccurrington@acmarketingpr.com
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SOURCE Cohere Health