Optum Rx will reduce reauthorizations on 40 additional medications Jan. 1, surpassing initial goals set out earlier this year.
The pharmacy benefit management arm of UnitedHealth Group first revealed earlier this year that it was aiming to reduce reauthorizations, a specific model for prior authorization, by up to 25%. The new additions bring the total number of drugs in the initiative up to 180, surpassing that 25% goal.
The new group of 40 medications includes therapies for chronic conditions and two new classes of drugs: hormone therapy and injectables for knee osteoarthritis.
In addition, Optum announced that it will expand the PreCheck Prior Authorization program, covering more than 45 medications beginning Jan. 1. The tool will reach 20 health systems, Optum said.
The tool automates the creation and approval of prior authorization requests, reducing the wait time for a determination from 8.5 hours to about 30 seconds, according to the announcement. Optum said the expansion will lead to faster approvals for about 75,000 physicians, with approvals coming through before the patient reaches the pharmacy counter, and, at times, before they leave the doctor’s office.
Optum said it piloted the tool with Cleveland Clinic and found 100% accuracy after one year and a 67% automation rate that cut appeals by 88%.
“It’s amazing to take what is already there in the chart to automate prior authorization without any additional effort from the physician, pharmacists or staff,” said Eric Boose, M.D., associate chief medical information officer at Cleveland Clinic, in the announcement. “I feel the promise and excitement of automation actually happening and working and hope it grows quickly.”