A natural way to frame this is to separate options where MedBridge owns and controls the technology from those where it relies on an external party. This surfaces the core tradeoff between speed and long-term control.

Own the technology:

• Build in-house: develop a proprietary digital authorization platform using internal or contract engineering resources. Maximum long-term control and customization but slowest to deliver, highest upfront cost, and most dependent on talent MedBridge likely does not currently have
• Buy and implement: purchase an existing healthcare technology platform designed for prior authorization workflows and configure it to MedBridge's needs. Faster than building from scratch, but still requires significant implementation work and carries integration risk with provider EHR systems

Rely on an external party:

• SaaS vendor: contract with a specialist prior authorization SaaS (software as a service) vendor that already has CMS-compliant digital workflows and EHR integrations built. Fastest path to compliance, lowest upfront cost, but creates vendor dependency and ongoing license costs that may exceed build costs over a 10-year horizon
• Third-party administrator: outsource the entire prior authorization function to a specialized third-party administrator that handles both the process and the technology. Removes the compliance burden almost entirely but is expensive, reduces MedBridge's control over a clinically sensitive function, and may create member experience risks

Given the 18-month constraint and MedBridge's lack of in-house technology capability, the SaaS vendor route is the most realistic path to compliance on time. A build or buy approach is unlikely to be implementable within the window. The strategic question for leadership is whether to stay on the SaaS platform long-term or use it as a bridge while building owned capability over a 3 to 5 year horizon.