VALER Voices: How OHSU is Setting Industry Benchmarks in Prior Authorizations

When Great Isn't Good Enough; VALER creates customized approaches for each of their clients

Spend any time around Ryanne Laurence or Joe Whipple from Oregon Health & Sciences University’s patient access team, and you’ll quickly sense that these two are passionate, talented individuals who are creating the curve in the industry. It’s been two years since OHSU implemented VALER, and we got a chance to sit down and talk through their discovery process, the optimization they’ve experienced, and what’s next.  


OHSU was already at the front of the pack when it came to streamlined processes, well-trained teams, and high levels of output. But they weren’t immune to the staffing challenges that so many have faced, nor were they complacent, as Ryanne puts it, “Patients aren’t going to stop coming, insurances aren’t going to stop making new policies…how do we, as the employer, as the manager, as the innovative IT world…how do we make it easier for the end user?” They wanted more automation, more visibility, and even further reductions in manual errors.


When Ryanne first came on board with OHSU, she was tasked with finding a software solution to optimize their prior authorization workflows. “What it came down to was who was willing to really collaborate with us…I wanted someone who would hear our pain points and be able to work with us to find some type of solution,” says Ryanne. Creating customized approaches for their clients is one of the hallmark traits of VALER.  “We’ve been able to work with the VALER team to build it to the specifications of what our team sees and feels is appropriate,” Ryanne further explains.


After two years into their journey with VALER, they have some impressive stats to share. When it comes to lead times, they were sitting at a respectable 4-5 days. That quickly jumped to 7 days and yet, when they most recently pulled their numbers, they saw an unprecedented average lead time of 13 days. This increase in lead time is building the margin that benefits the patient access teams, the providers, but most importantly, the patients.


How did they achieve these lead times? Through increased productivity. “I’ll speak specifically to our diagnostic specialty. In reviewing their productivity, we have a standard of 45 authorizations a day that we expect our team to touch and work through, and when we recently pulled our numbers, we saw that our average was actually 54 a an increase of 9 per day.” Ryanne says. She also went on to explain that they saw a 11% increase in diagnostic orders which they were able to accommodate without a staff increase.  


“There’s very much tangible results, but there’s also results that we’re seeing that we can’t pull a report and show you, but we feel it,” Joe shares in relation to how VALER has improved staff morale.  “Using the VALER tool has given [our employees] more transparency in their own work. They go in and can specifically see the authorizations they’ve submitted and see the outcome,” Joes says. “We all want to know that we are being successful.” Ryanne agrees and says, “When you talk about empowering employees, you can empower these folks who are already wonderful, great employees working as hard as they can, but it just shows you when you give them a tool that can make their work streamlined or more efficient, it’s going to benefit you and benefit your patients.”


Joe and Ryanne also feel that VALER and OHSU ultimately have aligned goals. “As a company, VALER is very much in the exact same mindset as we are, that patients come first,” Joe says. This points back to the genesis of VALER, co-founded by a pediatric surgeon fed up with the barriers in prior authorization and committed to finding real-world solutions. This alignment in goals creates a partnership atmosphere. “There is no better word for it; it’s definitely a partnership instead of a vendor relationship. It’s very much, ‘we’re in this together, let’s get it right together,’” says Joe. Steve Kim, VALER’s CEO agrees, “We very much see it the same way. It’s the only way to get work done.”


What does the future hold? Is touchless authorization on the horizon? Watch the full interview to see where VALER is headed.

VALER Voices: A New Approach to Optimizing Referrals and Prior Authorizations

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Adam Basua, of Community Memorial Health System, breaks down his process for optimizing the complexities of referrals and prior authorizations

In a recent interview, Adam Basua, Community Memorial’s Healthcare Management Leader, shares how he approached the challenges of optimizing referrals and prior authorizations for his team, and offers advice for those navigating the complexities of both.

         When Adam first joined CMHS, he knew they had a significant problem. They faced a lack of structure across their 15 locations with everyone, he describes, “doing their own thing”.  Without a centralized system, the lack of visibility made it challenging to identify, much less isolate, problematic processes. “So, who suffered? The patients,” Adam says with a heaviness. 

           Like so many others, Covid exposed weaknesses that couldn’t be ignored any longer; in many ways, Covid became the catalyst for change. With staff out sick on top of ongoing shortages, CMHS needed visibility across their clinics. Leaning on his background in IT, Adam sought a centralized, technology-based solution that would provide them with the automation and visibility they needed. After onboarding VALER, CMHS saw a night and day difference. They finally had an overview of productivity across their multiple locations, as well as the ability to  measure how much energy employees were putting into their roles. “All these intricate parts of the process can now be documented, and can be easily gathered with data,” Adam says.

         When asked what else has changed since CMHS brought VALER on board, Adam boasts cutting their referral submission time from 15 days to four, three, even two days. “Unheard of, we weren’t even close to this,” he remarks. That metric alone translates directly to better patient care. “Patients love the response time,” Adam explains and admits with a chuckle that their problem now is that “our doctors are spoiled.”  

         You might expect that these wins would be Adam’s favorite aspects of VALER, but when asked he smiles and says, “You’re going to laugh, but it’s just working with you.” Adam goes on to explain that his relationship with VALER isn’t like that of a typical vendor. “I feel like VALER is part of our organization,” he says. This is no accident; VALER intentionally cultivates the attributes of a partnership with their clients. In the words of Steve Kim, Voluware’s CEO (VALER’s parent company), “We consider ourselves part of the team. We are on the same team.”

         Before the interview wraps up, Adam shares his advice for those looking to implement a software-based solution to their referral or prior authorization process. He poses three core questions you should ask of any application you’re considering:

  1. Can the software talk to insurance portals? This is a must to removing the burden of manual processes.
  2. How well does the software integrate with your EHR? This is a critical component for streamlining.  
  3. Can it grab productivity data that allows you to hold staff accountable, reward high achievers, and properly assess staffing needs?

         The interview ends with Adam’s final statement, “If you take VALER away from me, I’ll quit.” We think he’s joking, but then again, maybe not. You can watch the full interview and other VALER Voices interviews HERE.