New Data Indicates Rapid Adoption of Electronic Prior Authorization, Positive Impact on Providers

Third release of ePA National Adoption Scorecard reveals new data on provider sentiment toward ePA and industry trends

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Feb 21, 2017, 06:00 ET

COLUMBUS, Ohio, Feb. 21, 2017 /PRNewswire/ -- CoverMyMeds, a leading electronic prior authorization (ePA) platform, working with a group of industry stakeholders, today issued the third release of the ePA National Adoption Scorecard. The report quantifies the impact of prior authorization (PA) to patients and providers, outlines current ePA implementation rates by payer, pharmacy and electronic health record (EHR) market leaders and details ePA legislation by state. View the report at epascorecard.covermymeds.com.

Thirty-three states have legislation pertaining to prior authorization, with 16 states calling for the use of the NCPDP SCRIPT Standard. Prior Authorization legislation by state is available at epascorecard.covermymeds.com

The burden of PA is significantly lower for providers exclusively using an electronic method. On average, providers who report using an electronic method to submit requests spend 2.5 fewer hours on PA per week.

Fifty-four percent of market leading EHRs, 90 percent of payers and 79 percent of pharmacies have an ePA solution available in the market. Learn which industry stakeholders have an available ePA solution at epascorecard.covermymeds.com.

Electronic prior authorization transforms the traditional, paper-based PA workflow into an electronic process that decreases prescription abandonment and administrative waste. Implemented properly, the ePA process provides real-time decision support for electronic prescribing and helps patients receive faster access to appropriate therapy.

The ePA National Adoption Scorecard highlights the following data on the impact of PA on patients and providers:

Seventy percent of claims rejected at the pharmacy require PA. Of those, 40 percent are abandoned each year.
The perceived burden of PA decreases significantly for providers who report exclusively using an electronic method for PA requests.
On average, providers who exclusively use an electronic method for PA requests report spending 2.5 fewer hours on PA each week.

The report also outlines the percent of the payer, pharmacy and electronic health record (EHR) suppliers who have committed to and implemented an ePA solution:

Fifty-four percent of market leading EHR systems have an available ePA solution, a 7 percent increase versus 2016.
Ninety percent of market leading payers have an available ePA solution, a 22 percent increase versus 2016.
Seventy-nine percent of market leading pharmacies have an available ePA solution, a 7 percent increase versus 2016.

The ePA National Adoption Scorecard is published by CoverMyMeds with an advisory group comprised of leaders from Express Scripts, the National Council for Prescription Drug Programs, Cerner Corporation, Cardinal Health, the National Alliance of State Pharmacy Associations and the Virginia Association of Health Plans.

"Market adoption and utilization of an electronic channel for PA is one of the most effective ways the industry can help prevent avoidable medical spending as a result of prescription abandonment, and help patients get the medication the need to live healthy lives," stated Perry Lewis, VP of Industry Relations at CoverMyMeds. "As the industry continues to experience a rise in drug costs and specialty medications, nearly all of which require PA, electronic PA channels that provide decision support to the provider and streamline the workflow of providers, pharmacists and payer organizations will be critical. We're thrilled with the progress the industry is making, and look forward to continuing to educate stakeholders on how they can leverage ePA."

Stakeholders interested in viewing the report may visit CoverMyMeds at booth 1214 at HIMSS17 on Feb. 19-23.

About CoverMyMeds
CoverMyMeds is a leader in electronic prior authorization (ePA) solutions, and one of the fastest growing health care technology companies in the U.S. CoverMyMeds' software suite automates the medication prior authorization process for more than 500 electronic health records (EHR) systems, 49,000 pharmacies, 700,000 providers and most health plans and PBMs. By ensuring appropriate access to medications, the company helps its customers avoid billions of dollars each year in administrative waste and avoidable medical spending caused by prescription abandonment. Visit www.covermymeds.com for more information.

SOURCE CoverMyMeds