The demand for clinical resources – including nurses – will increase dramatically across the healthcare industry as the number of older adults in the US spikes from 56 million in 2020 to 94.7 million in 2060. Adults 65 or older are more likely to have more than one chronic illness and require hospitalization three times more often than adults aged 45-64. At the same time, nurses themselves are reaching retirement age, and there are not enough newly trained nurses to replace them. The Bureau of Labor Statistics estimates the need for 1.1 million new registered nurses by 2022. As a result, hiring and retaining nurses is more challenging than ever.
Benefits of Delegating Nurse Initial and Concurrent Reviews
Payers must compete with hospitals and other industry stakeholders to hire and retain qualified registered nurses. Partnering with a utilization management (UM) organization, such as AllMed, to outsource nurse prior authorizations and concurrent reviews, can help address these problems.
- Lower costs of nurse recruitment, training, and management
- Offload management of fluctuating caseload volumes
- Gain access to flexible, scalable resources on demand
- Reduce nurse burnout to improve retention and engagement
- Allow internal clinical resources to focus on higher value-added initiatives
- Ensure that your reviews are compliant with state and federal regulations
- Increase productivity and competitive differentiation
Let Us Help Your Organization Excel
Offloading nurse prior authorizations and concurrent reviews to a UM organization, such as AllMed, helps payer organizations reduce employee burnout, retain valuable team members, and avoid some of the fierce and costly competition for nurses.
A 2018 American Medical Association survey described initial review including prior authorization as “a lengthy administrative nightmare of recurring paperwork, multiple phone calls, and bureaucratic battles that can delay or disrupt a patient’s access to vital care.” Most clinical staff regularly juggle a wide range of responsibilities. Having to balance multiple complex tasks, only one of which may be prior authorizations or concurrent reviews, is stressful and overwhelming. Burdening employees in this way lowers morale and can lead to costly errors and high turnover.
Instead, valuable team members can focus on initiatives that can help contribute to your success and competitive differentiation. By relying on AllMed’s team of expert nurses to complete your nurse prior authorizations and reviews, your organization is more efficient and productive. With our help, your employees have more opportunities to make critical contributions allowing your organization to excel.
Initial Clinical Reviews from AllMed
Our team of clinical professionals includes nurses who are highly skilled reviewers, not by default but by choice. AllMed’s dedicated team of registered nurses has considerable experience and skill overseeing and managing prior authorizations and concurrent reviews. We understand the volatility of the healthcare industry and the standards, policies, and regulations that impact utilization management reviews. With all of this in mind, we tailor our process to your specific needs and ensure review quality and integrity while controlling utilization.
Initial Clinical Review
Scale quickly and efficiently to meet changing demand for initial nurse prior authorization and concurrent reviews. Outsourcing to AllMed frees clinical staff to focus on higher value-added initiatives.