Featured on the CHIME Stage at ViVE 2026: Electronic Prior Authorization for the Real World
At ViVE 2026 in Los Angeles, the CHIME Stage hosted a focused panel discussion on one of healthcare IT’s most pressing challenges: preparing for the CMS electronic prior authorization (ePA) mandate ahead of the January 2027 compliance deadline.
Debra Carpenter, Ph.D., CHCIO, CHISL, CDH-E—Chief Information Officer at TriState Health and a valued member of the Blue Eagle Board—joined healthcare technology leaders from Infor and Claritev for the session titled “One Claim, Two Claim, Fast Claim, True Claim: ePA for the Real World.”
The panel explored what it will actually take to modernize prior authorization, and why success depends on both interoperability technology and workflow redesign.
Key takeaways from the discussion:
ePA is not a quick fix. Its greatest value is compressing the time between request and decision, not eliminating denials entirely. Faster responses allow care teams to adjust plans sooner and pursue appeals while there is still time.
Workflow redesign matters as much as the technology. TriState Health discovered that staff roles, handoff processes, and documentation timing all needed to be restructured before electronic workflows could deliver results.
The business case is built on measurable impact. Denial rates, staff labor hours, unused procedure capacity, and days in accounts receivable are the metrics that make the case for change across both finance and clinical leadership.
Most organizations will operate in a hybrid environment for years. Some payers will be fully FHIR-enabled while others still rely on manual processes. Flexible architecture is essential.
Smaller organizations may need outside expertise. As new regulations continue to evolve, critical access hospitals and smaller health systems often need specialized support to navigate compliance without disrupting daily operations.
Read the full executive summary published by CHIME
Is your organization preparing for the 2027 ePA mandate? Blue Eagle Consulting helps health plans and health systems navigate compliance with experienced clinical and IT consultants who understand the technology and the workflows behind it.