Utilization Management Vendor Analysis Guide
Published:
December 9, 2025
Prior authorization remains one of the most pressing challenges in healthcare, with legacy systems creating administrative burden, care delays, and frustration for both health plans and providers. Incremental improvements from portal‑based vendors often fail to address structural limitations, leaving organizations struggling to balance compliance with innovation.
To help health plans and providers evaluate their options, Cohere Health compared purpose‑built clinical intelligence platforms with legacy, portal‑only solutions that have retrofitted automation onto transaction‑based systems.
Download the guide to learn:
- How legacy systems fall short: Portal‑based platforms focus on transactions, layering AI/ML onto outdated infrastructure, resulting in inefficiencies and limited impact.
- Why clinical intelligence matters: Purpose‑built platforms combine advanced technology with clinical expertise to reduce administrative burden, deliver actionable insights, and support evidence‑based decision‑making.
- How automation and analytics reshape utilization management: Intelligent automation, transparent criteria, and advanced analytics enable health plans to improve provider satisfaction and streamline complex reviews.
- What transformation looks like in practice: Cohere’s platform achieves 93% provider satisfaction by meeting clinicians where they are, offering transparency, and enabling flexible approaches to modernization.
Learn how choosing the right platform can move prior authorization from a source of friction to a driver of efficiency, collaboration, and better outcomes for providers, patients, and health plans.
