How Prior Authorization Reform Could Help Patients and Providers
In this part three interview of a video series, Hari Prasad, CEO of Yosi Health, told Managed Healthcare Executive editors that cutting administrative burdens through digitized prior authorizations could improve patient outcomes and restore valuable time to physicians.
As major insurers renew their pledge to streamline the prior authorization process, healthcare leaders are calling for reforms that truly reduce administrative barriers to care.
Hari Prasad, CEO of Yosi Health—a company founded in 2015 to simplify healthcare workflows—believes this effort has the potential to deliver real improvements, but only if it results in measurable changes for both patients and providers.
One of the biggest pain points, Prasad shared with MHE, is the time physicians lose to documentation. Much of it is not just for prior authorizations but for a growing range of administrative tasks required by the healthcare ecosystem. That burden has a ripple effect, he said.
“As an ecosystem, we place a lot of burden on the physicians for proof of documentation, which eventually reduces the time that they spend with their patients,” Prasad said. “Then, if the day it's advert, it's adversely impacting patient outcomes, because physicians are required to spend a lot of time on these administrative processes.”
He added that reducing this load—whether through more efficient prior authorizations or better electronic medical records—would give doctors more time with their patients and speed up access to medically necessary care.
Delays tied to manual prior authorization processes often postpone time-sensitive procedures such as MRIs or specialist referrals.
Prasad said that even a few weeks’ delay can make a significant difference in a patient’s diagnosis and treatment timeline. He said that if digitization is done right, these delays can be meaningfully reduced.
However, skepticism remains.
A similar industry pledge in 2018 did little to change the landscape, and Prasad acknowledged there are still unknowns. For example, faster approvals could lead to higher procedure volumes, which might increase healthcare costs and insurance premiums. However, it’s not yet clear whether more approvals will consistently improve patient outcomes.
Overall, Prasad views the current moment as a promising opportunity. But, he warned, “It’s up to all of us to make sure that we are closely monitoring this, and as an industry, we’re moving the needle towards seeing this as a reality.”
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