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

Turning a patient’s own cells into powerful disease combatants — without the complexity of removing them from the body to do so — was a fantasy. Now it’s getting closer to reality. If drug developers like Capstan Therapeutics can make safe and effective in vivo CAR-T cell therapies, it could ease the huge scientific, manufacturing and cost challenges that have prevented transformative blood cancer treatments from being widely available. And it could open up the use of in vivo CAR-T cell therapies as a potential treatment for autoimmune diseases. To do so, Capstan is employing the mRNA technology behind the blockbuster Covid-19 vaccines. But the work is still in the early stages, and much remains unknown. “Two years ago, when I joined, it was kind of science fiction-y,” Capstan CEO Laura Shawver said. “Today we have line of sight [into the clinic], such that we’re going to understand, can this work in people and really be transformative?” Founded in 2021 as Teefib Biosciences, Capstan is bridging the worlds of its esteemed scientific founders from the University of Pennsylvania, including Nobel laureate Drew Weissman, CAR-T cell therapy pioneer Carl June, and cardiologist and stem cell biologist Jonathan Epstein. The startup’s approach draws from a 2022 Science paper published by the Penn researchers showing that a targeted lipid nanoparticle could be used to deliver mRNA to T cells and reprogram them into CAR-T cells — powerful agents of the immune system. Since its founding, It’s raised a total of $340 million in venture backing, from big names including Forbion, Sofinnova, RA Capital, Polaris Partners and others, as well as from drugmakers or their venture arms at Bristol Myers Squibb, Johnson & Johnson, Eli Lilly, Bayer, Pfizer and Novartis. This year, regulatory agencies in Australia and the US OK’ed the first clinical tests of in vivo CAR-T therapy in cancer patients. Interius BioTherapeutics and Umoja Biopharma were given the go-ahead to run human studies of their in vivo CAR-T therapies in the two countries, respectively. However, both companies are developing in vivo CAR-T treatments using an older technology with lentiviral vectors, as opposed to mRNA delivered via a fatty acid bubble. Moderna has also invested in in vivo cell therapy using mRNA. But it’s not yet known which approach — viral or nonviral — will yield the best results. While traditional CAR-T therapies have made their name as cancer treatments, recent clinical data have suggested they could be dramatically effective treatments for autoimmune disease as well. Capstan says it plans to start its first human studies in autoimmune disorders, though Shawver declined to lay out when the company expects to begin clinical trials. Shawver said that the company was in preclinical development and working through manufacturing steps, noting that their therapy involves a lot of different components. “A number of the companies are testing different technologies, and we will five years from now understand which of these technologies have entered the clinic, or will enter the clinic soon, is the more or most optimal of the in vivo approaches,” Shawver said. Key backers: Bristol Myers Squibb, Forbion, Johnson & Johnson, Mubadala Capital, Perceptive Advisors, Sofinnova Investments, Alexandria Venture Investments, Eli Lilly, Leaps by Bayer, Pfizer Ventures, Polaris Partners, Novartis Venture Fund, OrbiMed, RA Capital Management, Vida Ventures Find the full list of 2024 Endpoints 11 winners here .