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Compliance to Prior Authorization Mandates Is a Scope Challenge for Payers
»óǰÄÚµå : 1457844
¸®¼­Ä¡»ç : IDC
¹ßÇàÀÏ : 2024³â 03¿ù
ÆäÀÌÁö Á¤º¸ : ¿µ¹® 6 Pages
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US $ 7,500 £Ü 10,643,000
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ÀÌ IDC Á¶»ç´Â ÁöºÒÀÚÀÇ »çÀü½ÂÀÎ(PA)¿¡ ´ëÇÑ Àü¹ÝÀûÀÎ ºñÀü°ú ·Îµå¸ÊÀ» ¼ö¸³Çϰí, ±â¾÷ Á¢±Ù ¹æ½ÄÀ» ÅëÇØ PA¿¡ ´ëÇÑ Á¢±Ù¹æÇâÀ» ¸ð»öÇϰí ÀÖ½À´Ï´Ù. IDC Health InsightsÀÇ ¸®¼­Ä¡ µð·ºÅÍÀÎ Á¦ÇÁ ¸®ºêŲ(Jeff Rivkin)Àº "ÇÊ¿äÇÑ ±â¼ú ¾ÆÅ°ÅØÃ³ÀÇ ÀϺθ¦ ¸ðµâ½ÄÀ¸·Î ±¸ÇöÇÏ´Â °ÍÀÌ °¡Àå ÀûÀýÇÑ ¹æ¹ýÀÎ °ÍÀ¸·Î º¸ÀÎÀÔ´Ï´Ù. µµÀÔÇÏ´Â °ÍÀº ±×´ÙÁö ¸Å·ÂÀûÀÌÁö ¾ÊÁö¸¸, 'üũÇϱâ'¿Í '¹ú±Ý ÇÇÇϱâ'¶ó´Â »ç°í¹æ½Ä¿¡¼­ ¹þ¾î³ª´Â °ÍÀÌ Çö¸íÇØ º¸ÀÔ´Ï´Ù. Áö±ÞÀÚ´Â Àǹ«¸¦ ÃæÁ·½ÃŰ¸é¼­ Àϰü¼º, À¯¿¬¼º, ºñ¿ëÀ» ÃÖÀûÈ­ÇÏ´Â ±â¾÷ ¿î¿µ ¸ðµ¨·Î ¸ðµâ½ÄÀ¸·Î ÀüÈ¯ÇØ¾ß ÇÕ´Ï´Ù."¶ó°í ¸»Çß½À´Ï´Ù.

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This IDC study looks at establishing an overall vision and road map for prior authorization (PA) in payers and where the enterprise approach is going with its PA journey. Modularly implementing sections of the needed technology architecture seems the most appropriate path. "While less attractive to implement, pulling back from the 'check the box' or 'avoid the fine' mindset seems prudent. Payers should move in a modular fashion toward an enterprise operating model that optimizes consistency, flexibility, and cost while addressing compliance with mandates," says Jeff Rivkin, research director for IDC Health Insights.

Executive Snapshot

Situation Overview

Advice for the Technology Buyer

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