Welcome to the Empowered Patient Podcast with Karen Jagoda. This show is a window into the latest innovations in applying generative AI, novel therapeutics and vaccines, and the changing dynamics in the medical and healthcare environment. One focus is on how providers, pharmaceutical companies, and payers are empowering patients. In addition, conversations are often about how providers, care facilities, pharmaceutical companies, and payers are being empowered by technology to improve patient outcomes and reduce friction across the healthcare landscape.
Popular Topics
- Virtual and digital health
- Use of AI, ML, and LLM in healthcare and drug discovery, development, trials
- Value-based healthcare
- Precision and stratified medicine
- Integration of digital technology into existing workflow and procedures
- Next-generation immuno, cell, and gene therapies
- Vaccines
- Biomarkers, sequencing, and imaging
- Rare diseases
- MedTech and medical devices
- Clinical trials
- Addressing Social Determinants of Health
- Treating chronic conditions like obesity and pain
- Clinician and staff burnout
The audience includes life science leaders, researchers, medical professionals, patient advocates, digital health entrepreneurs, patients, caregivers, healthcare solution providers, students, journalists, and investors.
Check out our new EmpoweredPatient.Solutions site where you can quickly search all of the Empowered Patient Podcast interviews by any word or phrase to identify useful resources, potential partners, and insights about the life sciences landscape.
Jan 31, 2022
Matt Murphy is the EVP of Network and Clinical Content at Cohere Health, innovators in utilization management and prior authorization for tests, services, and drugs. By taking a patient-first approach means reviewing cases on behalf of the Cohere health plan clients as well as with an eye to the health outcomes of patients.
Matt explains," Utilization management really evolved as an adversarial exercise with health plans pitted against physicians. And if you think about the key areas where it's impacting patients and physicians more broadly, really it's three things. First is delays in care and access. Really there shouldn't be anything coming in between a patient and the care they need as long as it's clinically appropriate. So I'd say that's probably the first issue."
"A few weeks ago, we reported out jointly with Humana, one of our first clients, on the impact we had in year one, and it was tremendous in terms of medical expense savings. But I think it goes back to the philosophical differences people have in utilization management."
"On one side, you have a number of folks who think that the only way to drive down medical expense is to deny services versus our vision, which is if you truly are driving the right clinical care for patients and the highest value care, you're inherently going to have lower expense. So I think if you can kind of transition across that philosophical boundary into the focus on clinical outcomes, you inherently save money."
@CohereHealth #PriorAuthorization #UtilizationManagement
