Bring your market together. Cut paperwork, not care.

January is coming. States have an opportunity to turn the move to electronic prior authorization into a shared implementation effort — not another set of separate payer-provider connections.

The same plans, health systems and technology companies work across state lines. They should not have to recreate the same work in every market.

We do not need to harmonize state regulation to harmonize implementation.

Start with convening, not procurement

Name one state lead. Bring Medicaid, the insurance department, state employee health programs, commercial plans, hospital and provider associations, rural and Tribal providers where relevant, HIEs and existing technology partners to the table.

Ask what each organization already needs to deliver, where testing and onboarding are being repeated, and what can be reused from work underway elsewhere.

No new SHN program budget. No new technology procurement. Just a first shared conversation. Separately funded implementation and production participation can follow where needed.

Join the Cut Paperwork, Not Care effort

The coalition is a voluntary, state-led effort to reduce administrative cost and return resources to care. Participants share readiness discussions, synthetic-data testing and practical lessons across markets.

Implement once where possible. Test once where possible. Reuse the work wherever possible.

Organizations can participate in the discussions before they are ready to test. Joining the conversation is not a regulatory mandate or an automatic commitment to use a particular technology.

Delaware has started. Your state does not have to start from zero.

Delaware’s August 31 readiness session brought together 53 participants across plans, providers, DHIN and technology partners. The work focused on real constraints: limited testing capacity, provider reach, EHR gaps and repeated counterparty tests.

Use the shared Road to January to see the planned sessions and next opportunities to participate.

Build on what your state already has

Keep useful Medicaid systems, HIE services, payer APIs, provider relationships and workflow partners. Coordinate the implementation around them rather than commissioning a separate system for every requirement.

A state can also consider targeted support for practices that need integration, training or operating help. That is a defined purchase, not the price of admission to shared learning.

Make the result matter to people

A better implementation should mean fewer repeated requests, less time chasing information and a clearer answer to “what happens next?” It should return staff time to care rather than move more administrative work onto patients.

Name a lead. Bring the market. Start with the work already underway.

References to CMS, HHS, or CMS-0057 describe federal programs and requirements; Smart Health Network is not endorsed by CMS or HHS.