Availity to Acquire Utilization Management Solution and Business Unit from Olive

Game-changing investment in transformative artificial intelligence technology aligns with Availity’s vision for intelligent and fully automated authorizations between health plans and providers

Summation

  • “We saw a clear opportunity to acquire an automated, digital solution to one of the costliest and most manually driven workflows in healthcare—authorizations,” said Russ Thomas, CEO of Availity.
  • As a result, payers and providers can enjoy the benefits of lower administrative and medical costs, improved patient access and experience, and clinical data for making enhanced and strategic business decisions.
  • To date, automation of authorizations has been difficult because they require both administrative and clinical data, which are often stored in siloed information systems and in non-standardized formats that require manual intervention to bring together.

Availity, one of the nation’s largest real-time health information networks, announced a definitive agreement to acquire the utilization management solution and business unit from healthcare automation company Olive AI, Inc. This transaction also includes assuming the commercial contract with Olive’s current utilization management customers and hiring key associates dedicated to the utilization management business.

The acquisition strengthens Availity’s existing strategy to deliver an automated solution for end-to-end authorization transactions, which today remains driven largely by expensive, resource-intensive manual processes.

“We saw a clear opportunity to acquire an automated, digital solution to one of the costliest and most manually driven workflows in healthcare—authorizations,” said Russ Thomas, CEO of Availity. “This technology perfectly aligns with Availity’s vision of delivering omni-channel, multi-payer solutions to a fragmented healthcare data ecosystem. This game-changing solution will help our provider and health plan customers overcome the common barriers to ensuring timely care delivery, resource allocation, and patient satisfaction.”

Authorizations were created to optimize care paths and manage costs. However, Availity’s market research indicates that payers and providers collectively spend up to $13 billion every year managing an administrative process widely blamed for care delays, patient dissatisfaction, staff burnout, and friction between payers and providers.

To date, automation of authorizations has been difficult because they require both administrative and clinical data, which are often stored in siloed information systems and in non-standardized formats that require manual intervention to bring together. Availity’s AI auth solution leverages automation capabilities and Natural Language Processing (NLP) to streamline authorizations workflow, including:

  • Importing and structuring payers’ medical policies to automatically approve authorizations based on the codified medical policies.
  • Front-end capabilities that enable providers to simplify authorizations workflow.
  • Clinical data collection is automated and standardized, eliminating the multiple steps and handoffs in a manual workflow.
  • Reducing authorization approval time from days to seconds.

As a result, payers and providers can enjoy the benefits of lower administrative and medical costs, improved patient access and experience, and clinical data for making enhanced and strategic business decisions.

Availity Authorizations at HIMSS23

Learn more about the vision behind Availity’s AI auth solution at HIMSS23, April 17-21, in Chicago. Visit Availity at Booth 8336 or Meeting Place MP2284.

Transaction Details

The transaction is subject to customary closing conditions and is expected to be completed in the coming weeks. Additional details regarding the transaction were not disclosed.

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