Optum has officially launched a new program called Specialty Fusion, meant to reduce administrative hassle, manage specialty medication costs and perform best benefit evaluations.
The program will allow providers to use one portal to initiate the approval processes for specialty drugs requiring prior authorizations and see patients' diagnoses, as well as their pharmacy and medical coverage for certain medications, UnitedHealth Group's Optum subsidiary announced Thursday.
"The cost of the drugs, and the fact that they're covered under both the medical benefit and the pharmacy benefit, is part of the web that creates the difficulties in managing these drugs," said Kerri Tanner, senior vice president of OptumRx.
In synchronizing prior authorizations across both of a patient's benefits, they are able to start treatments faster, which is crucial as many specialty patients are polychronic and are already burdened by having to navigate coverage for 10 or more medications and multiple doctors, Tanner said.
From a provider perspective, she said physicians using Fusion can see a patient's treatment options, compared against dozens of other effective, lower-cost options, as well as the best sites of care, pharmacy networks and available discounts for patients across their benefits.