Change Healthcare, ASAM Partner on Utilization Management Software

Change Healthcare this week unveiled a software-as-a-service solution (SaaS) developed through a partnership with the American Society of Addiction Medicine (ASAM) designed to streamline operations for addiction treatment providers and payers.

The SaaS, known as the ASAM Criteria Powered by InterQual, integrates into existing care management workflows, reduces time required for substance use disorder patient assessments and streamlines prior authorization by using the industry-standard ASAM Criteria, the widely used set of guidelines for placement, continued stay, and transfer/discharge for patients with addiction and co-occurring disorders.

The tool is cloud-based and uses a Q&A format to simplify the ASAM Criteria and streamline the medical review process for SUD patients.

Laura Coughlin, Change Healthcare vice president of clinical innovation and development, said in a news release that the SaaS “brings much-needed efficiency to what until now has been an onerous process for utilization management.”

ASAM President William F. Hanning, III, MD, DLFAPAA, DFASAM, said the SaaS will help ensure consistent application of the ASAM Criteria “for all patients needing substance use disorder-level-of-care management.”

The ASAM Criteria are now required for level-of-care decisions for SUD patients in 20 states for providers and 7 states for payers. The Criteria are also encouraged by CMS for all Managed Medicaid coverage, except South Dakota.