Case Study: HCA reduces GLP-1 claim delays and manual prior authorizations with Conduent

HCA cuts 72-hour manual PA reviews with Conduent

HCA sought to control Medicaid spending on GLP-1 medications like Ozempic and Wegovy while preserving patient access. They needed to reduce their reliance on slow, manual prior authorizations and minimize inappropriate use without compromising operational efficiency or patient safety.

Conduent implemented a solution requiring specific diagnosis codes at the pharmacy point of sale. This allowed for real-time claims processing, which dramatically reduced manual prior approvals from 35 to often zero and gave members faster access to medication. The results streamlined pharmacy workflows for HCA, freeing staff to focus on policy work and ensuring therapies were used appropriately.

HCA