How can health systems deliver the right care at the right cost in the right setting, without overwhelming the delivery and reimbursement systems with administrative burden?

Today, prior authorization is a blunt instrument that the industry uses in an attempt to solve the nuanced challenge of how to deliver the right care at the right cost. What’s needed is a contemporary way for payers and providers to connect and communicate about cost and evidence at the point of decision.

Complicating this challenge: Both payers and providers are struggling with the complexity of modernizing legacy systems so they can sustain fee-for-service payment models while embracing coming value-based reimbursement models.

In his latest white paper, , Matthew Zubiller, vice president, strategy and business development at Web2pro, proposes an innovative model that provides a bridge to help achieve value-based decision support.

The paper describes a collaborative, exception-based approach that shifts interactions and decisions from post-care to point-of-care. It also prescribes a shared healthcare cloud that gives payers and providers transparency to evidence, quality and cost, as well as automates authorizations and approvals based on performance and care-event data.

 (PDF, 106 KB) to learn how this transformative model for exception-based utilization management and value-based decision making works.

Matthew Zubiller

About the author

Matthew Zubiller is vice president of strategy and business development at Web2pro. Zubiller specializes in innovative and disruptive technology strategies, with experience ranging from global strategy consulting to co-founding a spin-off from a leading Enterprise Resource Planning solutions vendor.

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