AI Takes on Healthcare's Biggest Headache in New athenahealth Deal

MENLO PARK, CA – December 18, 2025 – In a significant move to combat one of modern medicine's most persistent administrative burdens, AI platform Develop Health has launched a deep integration with athenahealth's athenaOne electronic health record (EHR). The partnership embeds an automated prior authorization (PA) engine directly into the clinical workflow, promising to save physicians hours of tedious work and accelerate patient access to necessary medications.

Effective today, the collaboration brings Develop Health's AI-powered automation into one of the most widely used EHR systems in the United States. For clinicians, the change is designed to be invisible. They will continue to prescribe medications within athenaOne as they always have, but in the background, Develop Health’s platform will automatically manage the complex and time-consuming prior authorization process from start to finish. This includes verifying benefits, identifying and submitting the correct payer-specific forms, and tracking the status until a final determination is made.

This integration directly targets a major source of physician burnout and care delays. The average physician navigates 43 prior authorizations every week, a process that has historically involved manually extracting clinical evidence from patient notes, filling out lengthy forms, and spending hours on the phone following up with pharmacy benefit managers (PBMs). By automating these steps, the partnership aims to convert hours of administrative labor into mere seconds of background processing.

The AI Prescription for Physician Burnout

The administrative fatigue associated with prior authorizations is a well-documented crisis in healthcare. It diverts valuable clinician time away from patient care and contributes to professional dissatisfaction. The new integration between Develop Health and athenahealth represents a direct technological intervention aimed at alleviating this pressure.

"Integrating directly into athenaOne allows us to meet clinicians exactly where decisions are made," said Mel van Londen, co-founder and CEO of Develop Health, in the initial announcement. "By automating benefit checks, and payer submissions at the moment of prescribing, we remove one of healthcare's biggest friction points. Patients get to therapy sooner, and clinicians get back meaningful time."

The system's intelligence goes beyond simple form-filling. Develop Health’s AI is designed to scan a patient's entire clinical history within the EHR, including past visits and lab reports, to pull the most relevant data required for a successful submission. This not only saves time but also significantly reduces the potential for human error, which can lead to denials and rework. While the process is automated, it maintains clinical oversight by giving providers an opportunity to review the AI-generated submission before it is sent to the payer, thereby increasing the likelihood of first-pass approvals.

Real-world impact has already been demonstrated. A case study with metabolic health company Calibrate revealed that implementing Develop Health's platform led to a 70% reduction in hands-on PA time and a five- to seven-fold decrease in the number of PAs required per member. These efficiency gains translate directly into more time for patient interaction and clearer, faster communication about treatment plans.

A Seamless Patient Journey, Unlocked by Integration

For patients, the prior authorization process is often an opaque and frustrating delay that stands between them and a needed therapy. This new, deeply embedded approach promises to make that waiting period shorter and more predictable. By operating seamlessly within the EHR, the technology eliminates the workflow friction that traditionally slows down the process.

Clinicians no longer need to toggle between their EHR and separate payer portals or fax machines. Updates on the PA status are fed directly back into the athenaOne workflow, providing clear visibility without manual checks. This streamlined communication loop ensures that both the provider and the patient are informed promptly, reducing the uncertainty that often accompanies prescribing complex or high-cost medications.

Develop Health’s platform differentiates itself by being “fully architected around GenAI,” utilizing over a dozen large language model pipelines to handle the nuances of medication access. This advanced AI enables it to connect with over 99% of insurance plans through a variety of submission methods—including electronic PA (ePA), fax, phone, and proprietary portals—a significant increase over the industry standard of around 80%. This comprehensive connectivity ensures that the automation works for nearly all patients, regardless of their insurance plan.

athenahealth's Strategic Play in an AI-Driven Market

This partnership is a clear indicator of athenahealth's broader strategy to solidify its position as an open, AI-native platform. Rather than building every feature in-house, athenahealth has cultivated a thriving ecosystem through its Marketplace program, which functions as one of the industry's largest EHR app stores. By integrating best-in-class solutions like Develop Health, athenahealth enhances the value of its core athenaOne platform and provides its vast user base with powerful new capabilities.

The move also sharpens its competitive edge in a crowded market. Competitors like CoverMyMeds and Surescripts have long offered PA solutions, but the promise of a truly “invisible” and deeply integrated GenAI-powered workflow could set a new standard for user experience and efficiency. This aligns with athenahealth’s stated goal of becoming an “AI-native” platform designed to cut administrative work for practices by more than 50%.

The integration with Develop Health is a key piece in this strategic puzzle. It addresses a critical administrative pain point with sophisticated AI, reinforcing the message that athenahealth is not just an EHR, but a central hub for intelligent, automated healthcare operations. For Develop Health, the partnership provides immediate access and credibility within athenahealth’s extensive network of over 150,000 providers, dramatically accelerating its market penetration.

Navigating a Shifting Regulatory Landscape

The timing of this integration is particularly astute, as it aligns with a major regulatory push to reform the prior authorization process. The Centers for Medicare & Medicaid Services (CMS) has finalized rules that will require payers to implement FHIR-based APIs for prior authorization by 2026 and 2027. These regulations are designed to force the industry toward greater electronic data exchange and automation, moving away from the antiquated world of faxes and phone calls.

By providing a ready-made, EHR-integrated solution, the athenahealth and Develop Health partnership positions their provider clients to be ahead of the compliance curve. The platform's ability to automate the extraction and submission of clinical data is precisely the kind of functionality that new regulations aim to encourage. As payers themselves adopt more automated intake processes to meet these mandates, provider-side solutions that can seamlessly connect to them will become essential infrastructure.

This proactive adoption of automation helps bridge the gap between provider and payer systems, creating a more fluid and standardized process that ultimately benefits the entire healthcare ecosystem. By tackling the PA problem with advanced AI now, both companies are not only solving a present-day challenge but are also building the framework for a more efficient and interoperable future in healthcare administration.