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Gold Carding Policies: Reducing the Barriers Between Payers and Providers.

Kavita V Nair1, Laura Stuursma1, Meghan Eigenbrod1

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Neurology providers face burdens from prior authorization. Innovative "Gold Carding" programs partner with payers to reduce these burdens, enabling better focus on high-quality neurologic care.

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Area of Science:

  • Neurology
  • Healthcare Administration
  • Health Policy

Background:

  • High-quality neurologic care requires efficient provider workflows.
  • Prior authorization and similar gatekeeper mechanisms create significant administrative burdens for neurology practices.
  • These burdens detract from direct patient care and provider focus.

Purpose of the Study:

  • To explore strategies for mitigating the impact of prior authorization on neurology providers.
  • To discuss the role of payer partnerships in streamlining access to neurologic services.
  • To highlight the potential of innovative programs like Gold Carding in improving care delivery.

Main Methods:

  • Review of current practices in neurology-based settings (solo, multispecialty, hospital, health system).
  • Analysis of various methods adopted to address prior authorization challenges.
  • Discussion of collaborative approaches with healthcare payers.

Main Results:

  • Different practice models employ diverse strategies to manage gatekeeper mechanisms.
  • Partnerships with payers, particularly through Gold Carding, show promise in reducing administrative load.
  • Streamlined processes allow providers to dedicate more time to patient care.

Conclusions:

  • Reducing administrative burdens is crucial for maintaining high-quality neurologic care.
  • Collaborative payer-provider initiatives, such as Gold Carding, are effective solutions.
  • Focusing on efficient care delivery pathways enhances the provider's ability to serve patients effectively.