The Future of PA is Clinical Automation

New healthcare legislation means that millions of additional Americans will have access to pharmaceutical benefits in the near future. Specialty pharmacy is the fastest growing component of pharmacy costs, with a 19.7% increase from 2008 -2009 (ESI 2009 Drug Spend Report).  Experts predict that specialty pharmaceuticals will account for more than 37% of total drug expenditures by 2020 and a nearly 50% increase by 2030.   While prior authorization is a valuable tool for plans and PBMs to manage specialty pharmaceuticals, the current manual and error-prone processes will not be able to handle the increased volume.  In addition, the workflow inefficiencies will add rather than remove cost.  The answer to this challenge is clear — an end-to-end integrated workflow process that  clinically automates the specialty pharmacy prior authorization process.

With Sanovia’s web-based PA-Logic™, plans and PBMs can:

• Reduce the administrative costs associated with prior authorization
• Improve clinical quality
  
• Ensure regulatory compliance for auditing and reporting
• Control drug spend for plan sponsors

You can save millions of dollars in administrative costs and drug spend by completely automating the prior authorization process. PA-Logic™ integrates real-time eligibility, benefits, formulary, and provider-network data with medical and pharmacy claims data, embedding best-practice clinical guidelines into the automated workflow for consistent clinical decision-making. PA-Logic™ automates the entire PA process from intake through fulfillment, ensuring timely payment and notification. 

Sanovia’s customers have experienced as much as a 65% improvement in prior authorization capacity, vastly improving the speed and efficiency of their PA process without adding new staff. In addition, they've seen noticeable improvements in member and prescriber satisfaction, greater consistency in decision-making, and a sharply reduced number of appeals in the PA process.