CareSource named winner of the Doyle award

DAYTON, Ohio (CARESOURCE) - CareSource was named a recipient of the 2023 Richard L. Doyle Award given annually by MCG Health, part of the Hearst Health network and an industry leader in technology-enabled, evidence-based guidance for Innovation and Leadership in Healthcare. CareSource was recognized for successfully collaborating with hospitals to transform the inpatient authorization process.

“This award from MCG Health is a true acknowledgment of CareSource’s commitment to create value for our state partners, to reduce administrative burden for all providers, and to ensure members receive timely, medically necessary care,” said Dr. David Williams, executive vice president and chief medical officer at CareSource.

The Richard L. Doyle Award for Innovation and Leadership in Healthcare is presented to two organizations — one payer and one provider — that use MCG solutions in exceptional ways to achieve improved patient care, reduce unnecessary costs and optimize efficiency.

CareSource’s winning initiative involved partnering with Cleveland Clinic and University Hospitals facilities to improve turnaround times for authorization responses and reduce administrative burdens.

MCG Health President and CEO, Jon Shreve said, “We congratulate CareSource on receiving the Doyle Award. It reflects their collaborative nature and technological determination. By embracing this path, they are improving the lives of their members and showing other payers and providers how to work together for a successful future.”

CareSource became one of the first adopters of MCG Cite for Collaborative Care, a platform using interoperability technology to connect payers and providers via their respective medical management and electronic health record (EHR) platforms. This process enables the payer and provider to avoid the tedious fax communication process and allow data interaction to happen in near real time resulting in less administrative burden for the Provider. This implementation reduced the time and effort for inpatient authorizations by six to seven minutes per review.

CareSource continues to drive provider adoption through its provider portal that leverages MCG’s Cite AutoAuth technology. This process led to faster and less burdensome experience for providers and timelier treatment for CareSource’s members.

The collaboration between MCG and CareSource reduced the time members waited to receive responses to their medical care requests by decreasing time spent between CareSource and the provider waiting on decisions and ensuring necessary medical information was obtained the first time. For cases received through Collaborative Care, there has been a 5.5% increase in first pass determinations leading to a reduction in Medical Director referrals for review.

“Providers are excited about the increase in near time communication and wish more payers would implement this bidirectional exchange of information,” said Christopher Tarr, CareSource’s director of clinical operations and clinical systems.