Baystate Health, with its health plan, Health New England, recently announced the Clear Path Pilot Program, a one-year pilot initiative to help nearly 1,200 eligible, fully employed Baystate Health providers deliver care to patients faster by reducing prior authorization requirements for more than 800 medical and imaging service codes. Health New England’s fully funded commercial members and Baystate Health’s employer group members are eligible for participation.

“The healthcare system is mired in outdated, administrative-heavy burdens that result in a fragmented and frustrating experience for patients, physicians and providers,” said Peter Banko, president & CEO, Baystate Health. “All too often these processes can lead to unnecessary friction between patient and health plan along with physician and health plan.”

By leveraging the capabilities of Baystate Health, as an integrated health system with a health plan, the Clear Path Pilot Program reduces administrative barriers for eligible patients and their care teams while maintaining clinical oversight, quality standards, and protections that ensure patients receive appropriate care. Direct communication between Baystate Health providers and Health New England, the use of shared clinical and utilization data, joint governance, and enhanced care coordination will lead to improved and streamlined access.

“Clear Path is designed to help patients receive medically necessary care more efficiently while preserving the safeguards that protect quality and safety,” said Dean Sanpei, interim president, Health New England, and chief administrative officer and chief strategy officer, Baystate Health. “By pairing fewer administrative steps for select services with robust data sharing, retrospective review and ongoing clinical oversight, we can evaluate this pilot’s more streamlined approach.”

As the pilot demonstrates its ability to reduce administrative burden while maintaining quality, Health New England will be positioned to expand the program to provider organizations that meet eligibility, data-sharing, governance, oversight and accountability requirements, and apply it to other health plan products.