Survey: Prior authorizations hurt patient outcomes
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Most doctors surveyed by the American Medical Association reported waiting a day or more for health plans to approve medicine or services for patients.
Survey results released by the American Medical Association (AMA) on Monday show the majority of doctors believe prior-authorization insurance companies sometimes require for medications and treatments hurt clinical outcomes.
Of about 1,000 physicians surveyed, 92 percent said the requirement that insurance plans sign off before a prescription or service is provided to a patient have a negative impact on patient outcomes. Nearly two-thirds reported waiting at least one business day to receive a decision from insurers, and nearly a third said they wait three business days, or longer.
The high wait times for preauthorized medical care have consequences for patients, according to the AMA. Seventy-eight percent of doctors reported prior authorization can sometimes, often or always lead to patients abandoning a recommended course of treatment.
In addition, a significant majority of physicians (84 percent) said the burdens associated with prior authorization were high or extremely high, and a vast majority of physicians (86 percent) believe burdens associated with prior authorization have increased during the past five years.
The survey findings show every week a medical practice completes an average of 29.1 prior authorization requirements per physician, which takes an average of 14.6 hours to process – the equivalent of nearly two business days.
To keep up with the administrative burden, about a third of physicians rely on staff members who work exclusively on the data entry and other manual tasks associated with prior authorization.
The survey findings support AMA’s ongoing initiative to make pre-authorizations less cumbersome for patients and providers.
The AMA and 16 other organizations banded together in January 2017 to call on the insurance industry to reform pre-authorization practices in order to ensure necessary medical care in a timely manner and reduce administrative burdens on physician practices. The organization has since joined forces with major insurers and other groups at making industry-wide improvements in the process.
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