Pioneering Move Unites Medical and Pharmacy Benefits, Enhancing Access, Affordability, and Adherence for Specialty Medications and Procedures
Healthcare technology pioneer DrFirst acquired substantially all assets of Myndshft Technologies, Inc., a provider of end-to-end real-time medical benefits and automated prior authorization (PA) software-as-a-service (SaaS). The strategic acquisition aims to improve the patient experience and expedite access to vital specialty medications, such as infusions and in-office injectables primarily covered by medical benefits. Combined with DrFirst’s platform and scale, the technology will also lighten the substantial administrative load on healthcare providers and their staff.
Founded in 2018, Myndshft is a unified platform that streamlines prior authorization and related services for both medical and pharmacy benefits. This innovative technology uses AI, machine learning, and robotic process automation (RPA) to automate and streamline complex benefits, pricing, and PA processes across various payers and therapeutic classes into one seamless, intuitive workflow. The Myndshft platform also supports labs, imaging, and other procedures covered under medical benefits, which are often prerequisites for patients prescribed specialty medications.
Managing PAs is a significant burden on medical practices because of time-consuming manual processes and lack of integration with electronic health record (EHR) systems. These challenges lead to avoidable resubmissions and delays, frustrating healthcare providers and patients alike.
“This acquisition is a significant step forward in the industry, which has largely solved these issues for medications covered by pharmacy benefits but has yet to turn its focus to the complex, expensive, and often life-saving drugs covered by a patient’s medical benefit,” said G. Cameron Deemer, CEO of DrFirst. “The category of insurance benefit – pharmacy vs. medical – should not dictate a lower level of transparency or efficiency for prior authorizations. It’s unacceptable that the patients who most urgently need these life-saving therapies typically wait the longest to receive them. This acquisition will allow us to expedite patients’ access to these crucial treatments.”
The Myndshft platform provides eligibility and benefits verification for 95% of insured patients across the United States and instantly verifies prior authorization requirements for more than 600 payers and thousands of health plans. By automatically prescreening PA submissions for errors and omissions and providing a dashboard for monitoring the status of all PA requests, the platform significantly reduces manual effort by more than 70% and cuts claims rework by 90%.
“DrFirst’s acquisition of Myndshft is a strategic move towards solving the prior authorization problem for specialty medications,” commented industry analyst Seth Feder, founder of OnTarget Advisors LLC and expert healthcare adviser at Third Eye Advisory. “Specialty medications, often covered by medical rather than drug benefits, represent a crucial aspect of improving access to care while reducing the burden on physicians and back-office staff. The combined expertise of DrFirst’s scale and success in medication management with the AI-driven Myndshft platform sets the stage for delivering enhanced patient experiences and reducing healthcare costs, both of which are industry imperatives right now. DrFirst eliminates inefficiencies in medical prior authorization without disturbing existing clinical workflows – a smart move as it will win over healthcare providers and quickly deliver value.
DrFirst’s integrated network – of 270 EHRs, nearly 500,000 healthcare providers, and nearly 100 million patients – has the technology, scale, and presence in electronic health record (EHR) workflows needed to quickly bring value and support to the U.S. healthcare market at scale.
“We were looking for the right partner with existing provider and patient workflows as well as expertise in integrating across the healthcare landscape to maximize the value of our innovative technology,” said Ron Wince, Myndshft founder and CEO. “We are excited to work within the DrFirst network to ease the administrative burden on healthcare providers and help patients access needed therapies and other services.”
The acquisition closed April 17, enabling DrFirst to bring “much-needed efficiency and time savings to an expanded client base,” said Drew Hunsinger, vice president of corporate business development at DrFirst. “This accelerates and amplifies our ability to support access, affordability, and adherence for patients taking specialty medications. We’re excited to leverage our extensive clinical and technical expertise to benefit a broader range of patients nationwide.”