Regional payer significantly improved member experience through staff efficiency and reduced prior authorization turnaround times

MADISON, Wis., March 28, 2023 /PRNewswire-PRWeb/ — MCG Health, part of the Hearst Health network and an industry leader in technology-enabled, evidence-based guidance, has named Quartz Health Solutions a recipient of its 2022 Richard L. Doyle Award for Innovation and Leadership in Healthcare.

Quartz is a provider-owned health insurance organization that serves nearly 370,000 customers in Wisconsin, Illinois, Iowa, and Minnesota. The Richard L. Doyle Award for Innovation and Leadership in Healthcare is awarded annually to two organizations — one payer and one provider — that use MCG solutions in exceptional ways to achieve optimal care. Quartz was recognized as the payer winner for its automation advancements in prior authorization. Through its innovative strategy, Quartz improved timelier treatment decisions for members, reduced certain costs of care delivery, and improved its staff’s efficiency.

“At Quartz, we are dedicated to putting our customers at the center of everything we do,” said Christina Salm, Quartz Medical Management Operations Vice President. “We are constantly looking for new ways to innovate and improve our processes in order to improve the experience of the members we serve. It’s an honor to receive the Richard L. Doyle Award in recognition of those efforts to advance our products and services.”

Leveraging MCG Cite AutoAuth, Quartz was able to double case reviewer productivity. The use of streamlined care guidelines made for faster and more efficient reviews, and the solution helped reduce the number of prior authorization requests that required clinical reviewer intervention. Results have included:

• An increase in reviewer completion from an average of 15 cases per day to 37 cases per day
• An increase from 50% to 80% of provider authorization requests submitted electronically
• $1.5 million in cost savings by utilizing auto-review features within Cite AutoAuth for durable medical equipment (DME) requests

The novel use of automation technology has also allowed Quartz to repurpose 10 full-time RN roles to focus on member-centric, high-touch complex case management, and more effective care coordination. This helped Quartz clinical staff operate at the top of their licenses rather than focus on manual, administrative tasks.

“Quartz Health receiving the Richard L. Doyle Award demonstrates their strong commitment to innovation and continuous process improvement,” said MCG President and CEO, Jon Shreve. “Their leadership recognizes opportunities to modernize care delivery so they can devote more time to improving health outcomes and experiences of their members.”

The Richard L. Doyle Award will be presented to the Quartz Health team during MCG’s annual Client Forum in Orlando, Fla., May 7-9, 2023.

About Quartz
Quartz Health Solutions, Inc. (Quartz) is jointly owned by Advocate Aurora Health, Gundersen Health System, UnityPoint Health and UW Health. The company manages four provider-owned health insurance plans: Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation. As a third-party administrator, Quartz also services self-funded health plans. Through an extensive provider network, Quartz focuses on local, community-based health care and services for nearly 370,000 customers who live in Wisconsin, Illinois, Iowa, and Minnesota. Quartz Health Solutions, Inc., Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation are separate legal entities. For more information, visit QuartzBenefits.com.

About MCG Health
MCG, part of the Hearst Health network, provides unbiased clinical guidance that gives healthcare organizations confidence in delivering patient-centered care. MCG’s artificial intelligence and technology, infused with clinical expertise, enables its clients to prioritize and simplify their work. MCG’s world-class customer service ensures that clients maximize the benefits of licensing MCG solutions – demonstrating improved clinical and financial outcomes. For more information visit http://www.mcg.com or follow our Twitter handle at @MCG_Health.

About Hearst Health
The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person’s health journey. Care guidance from Hearst Health reaches the majority of people in the U.S. The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase and MHK (formerly MedHOK). Hearst also holds a minority interest in the precision medicine and oncology analytics company M2Gen. Follow Hearst Health on Twitter @HearstHealth and LinkedIn @Hearst-Health.

Media Contact

Arri Burgess, MCG Health, (206) 389-5405, Arri.Burgess@mcg.com

Myranda Tanck, Quartz, (608) 471-4856, Myranda.Tanck@QuartzBenefits.com

SOURCE MCG Health