Vital Data Technology Recognized in Gartner Hype Cycle for U.S. Healthcare Payers, 2024

Vital Data Technology is proud to be recognized as a sample Intelligent Prior Authorization vendor by global research and advisory company Gartner in their just released Hype Cycle for U.S. Healthcare Payers, 2024. The latest payer Hype Cycle offers essential insights for strategic planning by monitoring the maturity and adoption rates of various payer technologies and deployment methods.

This recognition comes on the heels of being a named vendor in Gartner's October 2023 Market Guide for Intelligent Prior Authorization, U.S. Healthcare Organizations. Both notices highlight our commitment to delivering integrated, cloud-based utilization management solutions, and reinforce our position as a leader in transforming payer medical management with innovative, next-generation technology.

According to Gartner, Intelligent Prior Authorization (iPA) harnesses APIs, natural language processing (NLP), and AI to automate decision-making, data exchange, and workflows between providers and payers. This approach not only reduces administrative burdens but also enhances transparency and efficiency. By automating prior authorization processes, iPAs improve clinical and financial outcomes, offering a frictionless experience for consumers while earning their trust and reducing the risk of adverse conditions.

The importance of iPA is underscored by state and federal mandates like the CMS Interoperability and Prior Authorization Final Rule, which aims to enhance health information exchange and streamline the prior authorization process. According to a recent report from The New York Times, physicians report spending nearly two full business days managing PAs, contributing to high burnout rates and impacting care delivery. With only 26% of PAs being fully electronic, according to the Medical Group Management Association, there is significant room for improvement. The 2023 Council for Affordable Quality Healthcare (CAHQ) Index reports that the U.S. healthcare industry could save $18.3 billion annually by transitioning to fully electronic administrative transactions.

Emerging AI capabilities drive hyperautomation, enabling real-time PAs and expediting approval processes. However, obstacles such as varying payer requirements, incomplete provider information, and technology silos impede progress. Collaboration between payers and providers on data sharing and care management workflows is essential for advancing iPAs. Despite these challenges, the push for cost optimization, regulatory pressures, and the need to limit provider abrasion are driving iPA automation efforts. 

Vital Data Technology's Intelligent Prior Authorization (IPA) solution, part of our end-to-end Affinitē Utilization Management (UM) platform, leverages advanced automation to streamline workflows, verify benefits, and handle time-consuming administrative tasks. With the help of our CareFlow™ Rules Engine, Affinitē IPA empowers health plans to design customized authorization rules that align with their individual business requirements and regulatory obligations.

Affinitē IPA incorporates cutting-edge AI adjudication logic that analyzes utilization data and suggests enterprise-level solutions to optimize workflows and drive cost reductions. Additionally, the solution is built on a robust care platform that offers a comprehensive view of member data, including built-in data visualization tools powered by Power BI.

Click here for more information on Affinitē IPA.

Gartner members can access the full Hype Cycle report here.

Disclaimer: Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.