New Data Highlights Progress Toward Industry-Wide Adoption of Electronic Prior Authorization (ePA)

CoverMyMeds & industry stakeholders publish new data in second release of the ePA National Adoption Scorecard

 

  • Seventy percent of electronic health records (EHR) systems representing the majority of market share are committed to ePA, a 16 percent increase from March 2015
  • Eighty-seven percent of payers representing the majority of market share are committed to ePA, a 20 percent increase from March 2015
  • Eighty-three percent of pharmacies representing the majority of market share are committed to ePA, a 13 percent increase from March 2015
  • Twenty-three states have passed legislation pertaining to prior authorization (PA) and four additional states have pending legislation

COLUMBUS, OH – October 22, 2015 — CoverMyMeds, the nation’s largest electronic prior authorization (ePA) platform, and its industry partners today released an update to the ePA National Adoption Scorecard. The report, first released in March 2015, highlights the current state of ePA adoption across the health care industry. This release of the report includes updates to the ePA implementation status of EHR systems, pharmacies and payers. Since March 2015, the industry achieved a 10-20 percent increase in commitment to ePA functionality across all sectors of the industry.

The EHR category has seen significant movement since the initial publication of the ePA National Adoption Scorecard. Most notably, Cerner, Allscripts and eClinicalWorks announced ePA partnerships, and Epic and Practice Fusion launched live ePA functionality. Overall, the EHR segment achieved a 25 percent increase in live ePA functionality since March 2015.

A new section of this release of the ePA National Adoption Scorecard highlights ePA legislation impacting the industry. The report details 23 states with passed legislation pertaining to ePA, as well as four states – Missouri, New Jersey, Ohio and New York – with pending legislation.

The ePA National Adoption Scorecard is published with oversight from an advisory board of industry experts, including:

  • Lee Ann Stember: National Council for Prescription Drug Programs (NCPDP), President
  • Matt Moore: Cerner Corporation, Senior Strategist, Clinical Solutions Management
  • Nick Calla: Cardinal Health, Vice President, Industry Relations
  • Rebecca Snead: National Alliance of State Pharmacy Associations (NASPA), EVP and CEO
  • Adam Kautzner: Express Scripts, Vice President Formulary & Drug Trends
  • Doug Gray: VA Association of Health Plans, Executive Director

“As a pharmacist and advocate for the industry, specifically an advocate for the patient, I have seen the frustration from all parties when a prescription is denied due to cumbersome policies and procedures related to prior authorization,” commented Rebecca Snead, EVP and CEO of NASPA who authored the foreword for this release of the report. “My involvement in the ePA National Adoption Scorecard represents my commitment to improving the PA process. My hope is that through education the industry will join us in moving toward 100 percent ePA adoption.”

Overall, the report illustrates positive strides toward industry-wide adoption; however, there is still room for improvement.

“One area that requires more attention, and is often misunderstood, is the reach of payer ePA implementations,” indicated Perry Lewis, VP of Industry Relations for CoverMyMeds. “Sixty-eight percent of the largest payers have a live ePA solution; however, few extend ePA capabilities to all business lines. While payers work toward full implementation, providers need an ePA solution that allows for a consistent, electronic workflow, regardless of how the payer accepts the transaction.” He continued, “Not all ePA vendors deliver universal electronic compatibility today. Health systems need to be aware of this when selecting an ePA solution. We plan to further detail this in a future release of the report.”

The ePA National Adoption Scorecard is accessible online and available for download at epascorecard.covermymeds.com. Industry participants are invited to share data that will enhance the report by contacting the CoverMyMeds research team at [email protected].

 

About CoverMyMeds
CoverMyMeds is the leader in Electronic Prior Authorization (ePA) and one of the fastest growing healthcare technology companies in the US. They help physicians, pharmacists and their staff complete ePA requests for any drug and all health insurance plans. Their technology integrates with pharmacy systems, EHRs and PBMs to create the most efficient electronic prior authorization (ePA) strategy for all participants. With more than a million PA requests submitted each month, CoverMyMeds is the only vendor using the NCPDP SCRIPT Standard at scale. For information visit www.covermymeds.com.