BOSTON, July 28, 2021 /PRNewswire/ -- Cohere Health, an emerging high-growth digital health company, today announced a new solution for health plans in partnership with the American College of Cardiology (ACC) that actively engages physicians, patients, health plans and clinical ecosystem partners in shared patient decision-making to improve the quality of cardiology care, further avoid unnecessary medical expense, and improve patient experiences. Cohere's partnership with the ACC will integrate the medical association's evidence-based content into Cohere's episode-based, digital prior authorization platform.
Cohere's new cardiology digital collaboration module is the first utilization management solution that enables health plans to support patients, primary care physicians (PCPs), cardiologists, and pharmacy partners to work together on a single platform across episode-based cardiac care journeys. The patient-centric offering will expand capabilities of Cohere's highly successful digital prior authorization solution, while enabling more effective adherence to evidence-based cardiac care protocols and connecting cardiac patients and their PCPs to ACC educational programs.
Cardiac care, because of its increasing prevalence, chronic nature, and complex medication requirements, is one of the most intractable issues in healthcare today. According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death in the U.S., resulting in $219 billion in healthcare and medication costs.
"As a cardiologist, my greatest challenge in providing the best care for patients is eliminating inefficiencies and speeding the journey from initial presentation to the right diagnosis and therapy," said Dr. Carter Newton, MD, FACC, Associate Medical Director at Cohere Health. "A smart, coordinated process to guide patients along a care path with their primary physicians, cardiologists, diagnostic testing centers, interventionists and pharmacies is a major step in meeting that challenge. It is analogous to a supply chain solution in other industries. A cardiac problem originates at a point of care and efficient participation of the segments of care occurs quickly as information and priorities of need follow the patient to a solution. This is Cohere Health's plan."
Collaboration with the ACC enables broader use of Cohere's episode-based digital prior authorization solution to support cardiology care journeys. The ACC's mission is to transform cardiovascular care and improve heart health and envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. Cardiovascular disease remains by far the No. 1 cause of mortality worldwide.
"The ACC values teamwork and collaboration with all members of the healthcare team, including patients, to ensure each patient receives optimal cardiovascular care," said Brendan Mullen, Senior Executive Vice President, American College of Cardiology. "By integrating ACC's clinical content with the Cohere platform, we are sharing in their vision to give the entire healthcare team tools to work easily together, while also reaching patients and their PCPs directly with educational programs and administrative support."
Cohere Health's digital technology, including AI capabilities such as machine learning, enables a unique episode-based vs. transaction-based approach that drives substantial administrative and medical cost savings, plus much improved member experiences. Cohere then leverages that model to support collaboration across the entire care journey. For example, primary care physicians are notified of downstream cardiology events, such as cardiology-related prescriptions or advanced cardiac imaging requests, so that care can be better coordinated and reconciled to the patient's full medical history. This approach helps plans and members avoid unnecessary and potentially harmful services, such as contraindicated drugs, along with the unnecessary cost of such services.
"Our goal is to turn traditional utilization management into true care management in the future value-based world," said Siva Namasivayam, CEO of Cohere Health. "With our new cardiology solution and collaboration with ACC, we hope to connect cardiology care in a way that's never been done. The ultimate benefit will be great physician experience due to evidence-based guidelines recommended by their premiere professional association, even lower unnecessary medical costs beyond current utilization management programs, faster access to the right care, and better patient outcomes."
About Cohere Health Cohere's digital health plan solutions fundamentally transform utilization management to drive truly collaborative care journeys. Their solutions not only automate provider and payer preauthorization functions, but also generate clinical policy guidance that drives better care decisions without having to delay or deny care. Cohere then uses prior authorization as a trigger to engage plans, providers and patients in episode-based care paths that merge traditional utilization management, care management and patient engagement functions. Cohere's solutions also fully support pending CMS and state regulatory requirements, including immediate auto-determination, review turnaround times and FHIR interoperability standards. For more information, visit www.coherehealth.com.