Society management

Change Healthcare Partners with the American Society of Addiction Medicine to Transform SUD Utilization Management

NASHVILLE, Tenn.–(BUSINESS WIRE)–Today, Change Healthcare (NASDAQ:CHNG) launched The ASAM Criteria Powered by InterQual, a SaaS solution developed through an exclusive partnership with the American Society of Addiction Medicine (ASAM). This software, which integrates seamlessly into existing care management workflows, dramatically reduces the time required for assessments of patients with substance use disorders (SUDs), increases consistency and streamlines the pre-clearance process using industry standard criteria. ASAM criteria is a comprehensive and widely used set of guidelines for the placement, continued stay and transfer/discharge of patients with addictions and concurrent disorders.

“We are honored to launch this product in partnership with ASAM,” said Laura Coughlin, vice president of clinical innovation and development at Change Healthcare. “With a shortage of beds and dedicated wards to care for SUD patients, InterQual-powered ASAM criteria bring much-needed efficiencies to what has until now been a onerous utilization management process. More importantly, it will also help to ensure that patients/members receive the treatment that best suits their needs and that resources are used wisely.

The ASAM Criteria Powered by InterQual is an interactive, structured, cloud-based tool with an easy-to-use question-and-answer format designed specifically for usage management. It helps payers and providers streamline and improve the medical examination process for patients with SUD, reducing their administrative burden, while increasing consistency and simplifying documentation. It can reduce the time it takes to complete these assessments from 30 minutes to less than 15 minutes. (Previously, ASAM criteria existed only in print, e-books, and vendor reviews not designed for usage management.) In fact, during the first few weeks of use, The Holman Group, a service organization managed behavioral healthcare provider and a beta client, was able to complete primary exams in an average of seven minutes.

This simplified version of ASAM criteria is a great efficiency gain and will allow us to bring ASAM reviews in-house while helping us more easily meet state and CMS requirements,” said Elizabeth Holman, MBA, President of The Holman Group. “Before we had the ASAM criteria powered by InterQual, we did not have the tools internally to allow our examiners to apply ASAM criteria in care management decision making, and we probably couldn’t prove the IRR. Now, with this solution, staff can apply the criteria consistently and will be able to make decisions very efficiently and consistently. »

ASAM criteria powered by InterQual works within existing usage management workflows. The software allows case managers to easily assess each case comprehensively against ASAM criteria and provides the user with level of care and service recommendations within minutes. It includes all levels of care (LOC) for adults and adolescents, covering the entire ASAM continuum of care, all levels of withdrawal management services, as well as the six dimensions of assessment.

“ASAM is delighted to partner with Change Healthcare to bring this version of ASAM criteria market with a focus on usage management,” said William F. Haning, III, MD, DLFAPA, DFASAM, president of ASAM. “They designed a simple and elegant solution that fits perfectly with ASAM criteria and will help both providers and payers to ensure consistent application of these standards for all patients requiring level of care management of substance use disorders.

ASAM criteria is now required for level of care decisions for all patients with substance use disorders in 20 states for providers and seven states for payers, as well as encouraged by CMS for all Managed coverages Medicaid (except South Dakota). The ASAM Criteria Powered by InterQual is the only in-workflow usage management solution available to meet these ASAM criteria.

Payers and providers now have the ability to transform their SUD review process and a simple, efficient way to meet state mandates and the CMS-encouraged use of SUD reviews. Learn more about the ASAM criteria powered by InterQual here.

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About Change Healthcare

Change Healthcare (NASDAQ:CHNG) is a leading health technology company focused on insights, innovation and accelerating the transformation of America’s healthcare system through the power of the Change Healthcare Platform. . We provide data and analytics-driven solutions to improve clinical, financial, administrative, and patient engagement outcomes in the US healthcare system.