Nehi Inc

NEHI'S MISSION IS TO SOLVE COMPLEX PROBLEMS AND ACHIEVE VALUE IN HEALTH CARE BY FOSTERING INTERDISCIPLINARY COLLABORATION AND INNOVATION.

AUTOMATION OF PRIOR AUTHORIZATION:NEHI WAS FUNDED BY THE MASSACHUSETTS HEALTH POLICY COMMISSION (THE STATE'S COMMISSION OVERSEEING OVERALL HEALTH CARE SPENDING IN MASSACHUSETTS AND RECOMMENDING STEPS TO LIMIT SPENDING TO THE RATE OF GROWTH IN THE STATE ECONOMY) AND FOUR AUTOMATION TECHNOLOGY SERVICE PROVIDERS (CHANGE HEALTHCARE, COHERE HEALTH, HOOK MD, AND ZEOMEGA) TO ASSEMBLE A GROUP OF LOCAL PAYERS AND PROVIDERS AS WELL AS AUTOMATION TECHNOLOGY SERVICE PROVIDERS, ELECTRONIC HEALTH RECORD VENDORS, FEDERAL AGENCY REPRESENTATIVES, AND STATE AGENCY REPRESENTATIVES, TO PRODUCE ACTIONABLE AND PRAGMATIC RECOMMENDATIONS THAT WOULD REQUIRE MASSACHUSETTS PAYERS AND PROVIDERS TO AUTOMATE THE PRIOR AUTHORIZATION PROCESS WITHIN THE NEXT TWO YEARS. NEHI PARTNERED WITH THE MASSACHUSETTS HEALTH DATA CONSORTIUM (WHICH PROVIDED PRO BONO WORK) TO COMPLETE THIS PROJECT. NEHI AND MHDC CREATED A STANDALONE PRESENTATION THAT OUTLINES, FROM A TECHNICAL STANDPOINT, WHAT PAYERS AND PROVIDERS MUST DO TO AUTOMATE THE PRIOR AUTHORIZATION PROCESS, CONDUCTED A NEEDS ASSESSMENT TO DETERMINE WHAT STAKEHOLDERS WOULD REQUIRE TO AUTOMATE PRIOR AUTHORIZATION, AND PRODUCED A FINAL REPORT THAT INCLUDED NEHI AND MHDC'S RECOMMENDATIONS ("ADVANCING PRIOR AUTHORIZATION AUTOMATION ACROSS MASSACHUSETTS") IN APRIL 2023, FOLLOWED BY A WEBINAR IN MAY 2023 TO DISSEMINATE THE PROJECT WORK AND RECOMMENDATIONS.

ALZHEIMER'S DISEASE:NEHI RECEIVED PROJECT SPONSORSHIPS FROM ELI LILLY & COMPANY AND FROM EISAI INC. FOR A PROJECT THAT FOCUSED ON THE WIDE ARRAY OF INNOVATIONS EMERGING TO SCREEN INDIVIDUALS FOR DEMENTIA AND CONDUCT FOLLOW-UP ASSESSMENTS OF BRAIN HEALTH. THE PROJECT ENTAILED A SERIES OF EXPERT INTERVIEWS AND AN EXPERT DISCUSSION ROUNDTABLE HELD IN WASHINGTON, D.C. ON MAY 23 AT THE KAISER PERMANENTE CENTER FOR TOTAL HEALTH . EXPERTS CONSULTED BY NEHI INCLUDED SENIOR EXECUTIVES AT LEADING NATIONAL ORGANIZATIONS OF FAMILY PHYSICIANS, GERONTOLOGISTS, GERIATRICIANS AND OTHER CLINICAL PROFESSIONALS; PATIENT ADVOCATES; AND DEVELOPERS OF NEW DIGITAL DEVICES, ARTIFICIAL INTELLIGENCE APPLICATIONS AND LABORATORY TESTS THAT AIM AT DEMENTIA DETECTION. FINDINGS FROM NEHI'S RESEARCH AND INTERVIEWS FORM THE BASIS OF A FINAL REPORT THAT NEHI PUBLISHED ON SEPTEMBER 19, 2024, DETECTING DEMENTIA: EMERGING INNOVATIONS AND THEIR IMPLICATIONS FOR AMERICAN ADULTS AND THEIR HEALTH CARE. THE NEHI REPORT INCLUDES A SERIES OF RECOMMENDATIONS FOR UPTAKE OF INNOVATIONS THAT WILL ENABLE EFFICIENT AND AFFORDABLE DETECTION OF DEMENTIA AT A GREATER SCALE THAN COMMONLY OBSERVED TODAY.

CHCF PRIOR AUTHORIZATION:NEHI WAS FUNDED BY THE CALIFORNIA HEALTH CARE FOUNDATION (AN INDEPENDENT, NONPROFIT PHILANTHROPY THAT WORKS TO IMPROVE THE HEALTH CARE SYSTEM SO THAT ALL CALIFORNIANS HAVE THE CARE THEY NEED) TO GATHER AN ADVISORY GROUP OF CALIFORNIA PAYERS, PROVIDERS, CONSUMER ADVOCATES, AND POLICYMAKERS TO UNDERSTAND THE TOP ISSUES AROUND THE PRIOR AUTHORIZATION PROCESS AND MAKE RECOMMENDATIONS ON PRAGMATIC AND FEASIBLE SOLUTIONS TO ADDRESS THESE ISSUES. TO COMPLETE THIS WORK, NEHI DEVELOPED AN INTERIM REPORT, DETAILING CALIFORNIA'S HEALTH CARE LANDSCAPE AS WELL AS FEDERAL, STATE, AND VOLUNTARY PRIOR AUTHORIZATION REFORM EFFORTS OVER THE PAST DECADE AND CONDUCTED A STAKEHOLDER ASSESSMENT AMONG CALIFORNIA PAYERS, PROVIDERS, CONSUMER ADVOCATES, AND STATE AGENCIES TO COLLATE AND DESCRIBE THE TOP ISSUES ASSOCIATED WITH PRIOR AUTHORIZATION. NEHI ALSO DEVELOPED A FINAL REPORT DETAILING CONSIDERATIONS AND RECOMMENDATIONS FOR CALIFORNIA TO IMPROVE ITS PRIOR AUTHORIZATION PROCESS AND PLANNED A WEBINAR TO DISSEMINATE ITS WORK. NEHI ENGAGED THE MASSACHUSETTS HEALTH DATA CONSORTIUM AS A CONSULTANT THROUGHOUT THIS WORK TO PROVIDE TECHNICAL EXPERTISE AND FEEDBACK ON RECOMMENDATIONS TO AUTOMATE THE PRIOR AUTHORIZATION PROCESS.