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MCG Health’s well-respected evidence-based guidelines, in combination with Altruista’s automated clinical workflows, give payers and providers authoritative and efficient decision tools that support value-based care. 
Apr 16, 2020

Altruista Health Integrates MCG Cite AutoAuth into its GuidingCare Platform

Automated prior authorizations streamline health plan UM

(April 16, 2020, Reston, Va.) – Altruista Health today said it has integrated the Cite AutoAuth solution from MCG Health into its GuidingCare® technology platform to help health plans automate and streamline their prior authorization processes. The integrated solution is now available to health plans who rely on the Utilization Management (UM) module in GuidingCare, Altruista’s care management platform. Health plans can leverage this capability to significantly reduce medical review turnaround times and overtreatment, as well as better apply staff resources.

“Altruista health plan customers can now ease the administrative burden for providers and speed the delivery of care to plan members,” said Jon Shreve, MCG Health President and Chief Executive Officer. “Faster response times mean improved provider and member satisfaction. In addition, health plan staff will be more satisfied as they concentrate on prior authorization requests that require a higher level of review.”

Health plans can leverage the integrated solution to reduce unnecessary medical care that creates huge costs to the system. An estimated 20 percent of medical care provided today is unnecessary, according to a survey of American Medical Association physicians. Doctors say their challenges in curbing this care include the difficulty of accessing previous medical records, pressure from patients and fear of malpractice.

MCG Health’s well-respected evidence-based guidelines, in combination with Altruista’s automated clinical workflows, give payers and providers authoritative and efficient decision tools that support value-based care. Altruista customers can leverage plan-specific business rules to immediately authorize many routine procedures and tests, and alert providers to interventions that need further review or are not covered by a member’s plan.

“Leveraging evidence-based guidelines in a streamlined process aligns health outcomes with process efficiency,” said Craig Wigginton, Altruista Health Chief Technology Officer. “This integration supports the clinical quality that is foundational to GuidingCare’s automated workflows.”

About Altruista Health

Altruista Health delivers care management and population health management solutions that support value-based and person-centered care models. Our GuidingCare technology platform integrates care management, care coordination and quality improvement programs through a suite of sophisticated yet easy-to-use web applications. GuidingCare is the largest and most widely adopted platform of its kind in the United States. Founded in 2007 and headquartered in the Washington, D.C. area, Altruista Health has grown into a recognized industry leader, and was named twice as one of the Top Population Health Management Companies to Know by Becker’s Healthcare. Health plans and healthcare providers use GuidingCare to transform their processes, reduce avoidable expenses and improve patient health outcomes.

About MCG Health

MCG Health, part of the Hearst Health network, helps healthcare organizations implement informed care strategies that proactively and efficiently move people toward health. MCG’s transparent assessment of the latest research and scholarly articles, along with our own data analysis, gives patients, providers, and payers the vetted information they need to feel confident in every care decision, in every moment. For more information visit www.mcg.com or follow our Twitter handle at @MCG_Health.

 

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