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Another fast-paced, adrenaline-fueled quarter flew by here at Banjo Health leading to the development of a new solution that can reinvent current processes around PA criteria creation. With solutions aided by AI encompassing the complete PA process flow beginning with clinical criteria creation and ending with PA decisions, Banjo has poised itself to become the preeminent leader in PA technological solutions.
Q3 Banjo Highlights:
Beyond the complexities already well documented regarding PA decision-making and management, Banjo has recognized the need for clinical criteria creation automation through Artificial Intelligence. A common and shared frustration amongst clinicians everywhere involved with PAs will soon be streamlined through Banjo's proprietary AI that can read criteria instantly and automate decision tree creation and entry into any PA management platform.
The Banjo team continues to grow and add exceptionally talented team members each quarter. Banjo is proud to bring on three additional members this quarter that share the same team values, culture, and passion for growth that has shaped the team thus far.
A company-wide goal was successfully implemented that establishes OKRs as the guiding beacon for the goals and objectives set at every level of the Banjo hierarchy.
In a recent AMA survey, there were alarming statistics from the physicians they polled:
91% of respondents reported that a PA delayed access to necessary care
PA delays led to patients abandoning their recommended course of treatment according to 74% of the physicians
24% of physicians said that PA processes have led to a serious adverse event for a patient in their care.
The time is now for serious and impactful change to the prior authorization process to avoid unnecessary stumbling blocks for patients. These delays caused by slow PA processes can cause devastating and critical life-threatening events to patients which is strong motivation here at Banjo. The quote below represents Banjo’s philosophy to this systemic problem:
“Dreams are the seeds of change. Nothing ever grows without a seed, and nothing ever changes without a dream.” - Debby Boone, singer, author, and actress
Banjo is ready to take on PA and partner with forward-thinking leaders who believe in the “seeds of change” as much as the Banjo team does.
Thomas Evans - Data Architect/Developer
Q: What inspired you to join Banjo Health and why did you feel it was a fit for your current and future goals?
Tom: I have worked with James Rollins, the CTO of Banjo Health, for many years and when he asked me to come on board with Gia Miramontes, man, was I stoked. The three of us make a really great team and it was awesome that we could continue to work together. I have worked for a few startup companies and I love how they are full of energy and innovation. When James described the technologies that we would be implementing, I was definitely all in. It is good to keep up with advancing technologies. In more mature companies, funding is tighter, and technology may be harder to justify. This can limit what technologies can be implemented so your knowledge can stagnate. Just in this first year alone, I have learned more than I have in the previous five!
Q: What makes you excited about the future of Banjo Health in regard to its goal to simplify PA?
Tom: I got my start in the IT world doing what I am doing now…. Optical Character Recognition. That was in the early 90’s. It was implemented to speed up claims processing in the beginning. So, it seems that I have come full circle. I am excited that we can make the decisions in seconds upon receipt of the document. I am hoping at some point that we can take the document faxing completely out of the equation.
I think getting a decision returned to a provider for a patient that really needs to get the drug is imperative. With a family member that was diagnosed with cancer, it took weeks to get his approval to start needed immunotherapy. Wouldn’t it be beneficial for the patient to get a rapid approval so they can start that treatment sooner rather than later? So, yes, we are a for-profit company. But we are a company with a mission.
Q: What is your favorite food?
Tom: OK, this is harder than the other questions. I am a foodie. I like good, well prepared seasonal food. I tend to go for savory things. I watch my diet and limit my carbs but always have a craving for home-made Italian foods even though I have no Italian bloodline. One of my weaknesses is English pies…. Steak and ale, chicken and leek, or Melton Mowbray pork pies are the best.
Q: What do you enjoy doing outside of Banjo? What are your favorite hobbies?
Tom: Outside of Banjo Health, I am president and co-owner of the Red Dragon Brewery in downtown Fredericksburg. The Red Dragon is about four years old now and we are rated in the top 30 breweries in the US. I used to be a homebrewer (which I why I now have a commercial brewery) but now, I just do all the backend duties like taxes, payroll, making orders, HR duties, etc. When I am not running the brewery, I love to golf. My golf club is just a mile away and you can find me there afternoons after work. I am also a lawn care nut. Like my love about the chemistry and biology of brewing, I like learning and expanding my knowledge about the complexities of turf management. “Get your turf right”.
If you would like to learn more about current and future positions at Banjo, please visit the careers section at BanjoHealth.com.
In the PA marketplace, there has been a recent push accelerated by COVID-19 for Prior Authorization reform. On the federal level, there is bipartisan support including 234 members of U.S. House of Representatives that have co-sponsored a bill (HR 3017) that would modernize the PA process for Medicare Advantage plans by increasing transparency and standardizing PA. Even though the bill was introduced in 2019, the milestone of 50% sponsorship was only reached in the past few months as the struggles with obtaining PAs during the COVID crisis has intensified the call for change to ensure all patients have the access to the appropriate care in a timely manner.
Two years have nearly passed after an organization of health care providers including AHIP, BCBSA, APhA, AMA, and others came to a consensus statement to identify the five areas of improvement in the PA process that will provide significant reformation in the industry. AMA president, Susan R. Bailey, MD, said about the consensus, “Almost two and a half years after our consensus statement, the sad fact is little progress has been made toward the reform goals. The health insurance industry’s failure to achieve agreed-upon improvements illustrates a clear need for legislation like The Improving Seniors’ Timely Access to Care Act, H.R. 3107, to rein in prior authorization practices that adversely affect patient health.” Banjo is capable of solving all five of the areas of improvement identified in consensus to provide the meaningful enhancements that are long overdue. If you would like to learn more about Banjo’s thoughts on the PA landscape, please contact us at contact@BanjoHealth.com or visit Banjohealth.com to Get In Touch.