Polaris Group

Prior authorization automation platform Cohere Health and MCG Health, part of the Hearst Health network that provides evidence-based care guidelines, announced they will integrate their content and technology offerings to enhance the prior authorization process for providers, patients and health plans. The aim is to integrate MCG care guidelines into Cohere's Unify Decisioning tool to build a solution for prior authorization decision-making, driving higher rates of clinically relevant auto approvals while decreasing provider submission time and friction. The companies said a large regional insurer that intends to launch the two companies' combined platform in early 2005 will be their first client. The partnership is designed to benefit joint health plan clients and their provider networks and patients. As a result of the integration, health plan clinical review staff members can view indications, pre-filled by Cohere models within MCG Cite CareWebQI. Cite CareWebQI aims to ease access to evidence-based best practices and criteria to support clinical decision-making. In addition, health plans, payers and insurers can track members and episodes while monitoring and identifying variances from best practices. According to the two companies, Cohere's AI-driven technology is expected to lower time to care and MCG's clinical guidelines are intended to drive steady, clinically relevant care decisions. "MCG Health is the perfect partner to complement Cohere's groundbreaking, AI-driven offering with industry-leading and nationally recognized clinical criteria," Siva Namasivayam, CEO of Cohere Health, said in a statement. "Our leading, proven technology innovations applied to MCG's substantial clinical guidelines footprint will accelerate a new era of less prior authorization friction. Healthcare constituents are increasingly demanding innovative solutions that provide lower costs and faster access to care." THE LARGER TREND In April, Cohere Health and health insurer Humana expanded their 2021 partnership, which focused on the prior authorization process for musculoskeletal issues, to include diagnostic imaging and sleep services. Through the expanded partnership, diagnostic imaging and sleep solutions would be added to the services Humana offers its members and providers via Cohere Health. In 2021, Cohere Health secured $36 million in Series B funding. Polaris Partners led the round, with participation from investors Longitude Capital and Deerfield Management. Also contributing to the funding round, Flare Capital Partners and Define Ventures. In 2016, consumer engagement software company PegaSystems partnered with MCG Health to join forces in the Pega Care Management Application. The app puts patient records in one unified, collaborative platform, permitting each member of the care team to access information and oversee patient care.

Intelligent prior authorization platform plus leading clinical criteria enhances provider experience, improves health plan efficiencies, and accelerates patients' time to high-quality care BOSTON and SEATTLE, Oct. 8, 2024 /PRNewswire/ -- Cohere Health®, a recognized leader in clinical intelligence and prior authorization automation, and MCG Health, part of the Hearst Health network and a leader in technology-enabled, evidence-based guidance, announced they will integrate their content and technology offerings to improve the prior authorization process for providers, patients, and health plans. The partnership's first joint health plan client is a large regional insurer that plans to launch the combined solution in early 2025. Continue Reading MCG Health - Part of The Hearst Health Network The partnership will seamlessly integrate MCG care guidelines into Cohere's Unify Decisioning automation tool to create an industry-leading solution for prior authorization decision-making, driving higher rates of clinically appropriate auto-approvals, while reducing provider submission time and friction. The collaboration between the two companies will significantly benefit joint health plan clients, their provider networks, and patients. For health plans, clinical review staff will be able to view indications pre-fulfilled by Cohere Models within MCG Cite CareWebQI, enabling much faster reviews. Patients stand to benefit the most from this partnership, as Cohere's AI-driven technology will reduce time to care, while MCG's widely accepted clinical guidelines will drive consistent, clinically appropriate care decisions. "The partnership between Cohere and MCG Health will provide a powerful, unified solution to reduce administrative burdens in prior authorization," said Jon Shreve, CEO, MCG Health. "Both organizations are respected as innovators in healthcare technology and together, we can accelerate our progress to support payers, providers, and most importantly, patients." "MCG Health is the perfect partner to complement Cohere's groundbreaking, AI-driven offering with industry-leading and nationally recognized clinical criteria," said Siva Namasivayam, CEO, Cohere Health. "Our leading, proven technology innovations applied to MCG's substantial clinical guidelines footprint will accelerate a new era of less prior authorization friction. Healthcare constituents are increasingly demanding innovative solutions that provide lower costs and faster access to care." For more information about the combined Cohere-MCG solution, please visit: . About Cohere Health Cohere Health is a clinical intelligence company that provides intelligent prior authorization as a springboard to better quality outcomes by aligning physicians and health plans on evidence-based care paths for the patient's entire care journey. Currently processing nine million intelligent prior authorization requests annually, Cohere positively impacts more than 15 million health plan members and 492,000 healthcare providers nationwide. The company is a Top 5 LinkedIn™ Startup, winner of the TripleTree iAward, three-time recipient of KLAS Research's Points of Light, and has been named to Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists. Cohere's investors include Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners. 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, enable its clients to prioritize and simplify their work. MCG's world-class customer service ensures its clients maximize the benefits of licensing MCG solutions – demonstrating improved clinical and financial outcomes. For more information visit . CONTACT: Kat Long anthonyBarnum Public Relations [email protected] Arri Stewart MCG Health Tel: (206) 389-5405 [email protected] SOURCE Cohere Health WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

‘Undruggable’ targets aren’t just in oncology. Cardurion Pharmaceuticals is hoping to become the first to successfully develop a treatment for a genetic heart condition that researchers have been studying for decades. The startup is working on a rare heart disease known as catecholaminergic polymorphic ventricular tachycardia — CPVT for short — that can lead to abnormal heart rhythms and is estimated to impact one in 10,000 people. To do so, it’s using a CaMKII inhibitor and has become the first to put such a drug into human studies. It’s not an easy target. CaMKII is a protein kinase that is involved in both heart function and human memory — meaning that any drug going after it has to be extra precise. Cardurion CEO Peter Lawrence told Endpoints News that big pharma companies they are in contact with “were really intrigued by the fact we were able to get into human clinical testing with the CaMKII inhibitor because other major pharmas and biotechs have tried for a very long time — and it was hard to do.” Cardurion’s plan to develop the next generation of heart disease treatments involves a mix of internal research and external hunting. Founded by cardiologist and seasoned industry executive Michael Mendelsohn, who previously led cardiovascular research at Merck Research Laboratories, Cardurion launched in 2017 through a partnership deal with Takeda. As part of that partnership, a cardiovascular research team from Takeda’s site in Shonan, Japan turned into Cardurion’s drug discovery unit. Along with its CaMKII inhibitor, the Massachusetts-based company has clinical trials for heart failure studying two PDE9 inhibitors, one of which was a failed blood disorder treatment that Cardurion is looking to revive. In May, the company touted biomarker results from its Phase 2 study of one of those inhibitors. The company declined to disclose exactly how much money it has raised, beyond saying it’s somewhere north of $500 million. That includes a $260 million Series B that Cardurion announced in July and part of a $300 million commitment from Bain. “What we do is translate our expertise in cardiovascular signaling pathways into therapeutics for our patients. That is the scientific thesis that undergirds everything that we do,” Lawrence said. “We are constantly thinking about what could be attractive targets to pursue in various diseases. And we don’t talk a lot about what we’re looking at, because it’s proprietary, but it is no different than oncology.” Key backers: Ascenta Capital, Blue Owl Capital, Delos Capital, Digitalis Ventures, Farallon Capital Management, Fidelity Management, GV, Millennium Management, New Enterprise Associates, The Invus Group, Bain Capital Life Sciences and Bain Capital Private Equity, Polaris Partners, Takeda Pharmaceuticals Find the full list of 2024 Endpoints 11 winners here .