POCP Blog

CDS Hooks Are Win-Win-Win for Providers, Patients and Health IT Vendors

By Michael Burger, EDI Practice Lead CDS Hooks are a new SMART on FHIR technology that will enable providers to receive timely information about individual patients, their condition and potential …

Diving Deeper into CMS’ Proposed Rule on Electronic Prior Authorization for Medicare Part D Drugs

By Jocelyn Keegan, Payer Practice Lead, and Ken Kleinberg, Innovative Technologies Practice Lead The Center for Medicare and Medicaid Services (CMS) recently announced a proposed rule that would require use …

Emerging NCPDP Standard Enhancements to Improve Speed to Therapy for Specialty Medications

By Pooja Babbrah, Practice Lead, PBM Services Specialty medications are changing health care, providing life-saving treatment options for patients with rare and chronic conditions.  Patients, however, often face big hurdles …

Well-Intentioned CAQH Releases PA Operating Rules for Disappointing X12 278

By  Ken Kleinberg, Practice Lead, Innovative Technologies CAQH’s (Council for Affordable Quality Healthcare) recently released their new Phase V CORE Operating Rules for prior authorization (PA) that improve on specificity …

CARIN Alliance Workgroup to Help Advance Real-Time Pharmacy Benefit Check for Patients

By Pooja Babbrah, Practice Lead, PBM Services  The CARIN Alliance—a large, multi-stakeholder coalition–has formed a workgroup aimed at advancing the consumer-facing, real-time pharmacy benefit check (RTPBC). The goal is to …

Urgent Need for Real-Time Pharmacy Benefit Check Confirmed in Senate Committee Hearings

By Pooja Babbrah, PBM Services Practice Lead In mid-March, I was invited to testify in front of the U.S. Senate Special Committee on Aging at a hearing they held focused …

Health IT Will Help Achieve the Value in Value-Based Care in 2019

By Tony Schueth, CEO & Managing Partner How we pay for health care is undergoing a disruptive, fundamental shift. We rapidly are moving away from the traditional fee-for-service, pay-for-volume approach …

Efforts to Automate Specialty Pharmacy Will Accelerate in 2019

By Tony Schueth, CEO and Managing Partner Specialty medications are high-cost, complex drugs with special handling and delivery requirements. They are primarily used to treat rare or chronic conditions. Retail …

Electronic Prior Authorization On the Radar to Improve Medication Access

by Tony Schueth, CEO & Managing Partner A growing number of medications require prior authorization (PA) before they can be dispensed. This is a concern among providers, who are very …

Feds’ Year-End Guidance Will Affect Electronic Prescribing and EHRs

By Tony Schueth, CEO and Managing Partner The world of health IT was buzzing this week in the wake of a massive rule drop by the Office of the National …