Musculoskeletal (MSK) spending keeps climbing faster than expected.
Prior authorization (PA) does what it’s built to do: screen claims and stop the wrong care from being delivered at the point of service. But by the time a member is in a surgeon’s office requesting an authorization, the path is usually already set. They’ve decided surgery is the right option, or their condition has progressed to where that level of care is genuinely warranted. While the PA process is doing what it was built to do, it missed the opportunity to potentially redirect the care far earlier through proactive engagement with the patient.
In this webinar, hear from leaders at Humana, Carelon and TailorCare on managing MSK spend further upstream. See how patient engagement and navigation can complement UM by reducing avoidable prior authorizations and improving the member experience.