AMA: Prior authorization hurdles cause negative health outcomes

More than 90% of physicians reported prior authorization requirements had a negative impact on patient clinical outcomes and that prior authorization procedures held up patient access to necessary care, according a new AMA survey.

The poll of 1,000 practicing physicians suggests that widespread calls for health care reform that makes the patient-physician relationship more valued than paperwork have failed to produce a significant impact, an accompanying press release stated.

Survey findings include:

91% said the prior authorization procedures held up patient access to necessary care and that prior authorization programs had a negative impact on patient clinical outcomes.
88% felt burdens tied to prior authorizations increased during the past 5 years.
86% reported burdens tied to prior authorizations were “high” or “extremely high.”
75% indicated prior authorizations at least sometimes resulted in patients calling off a recommended course of treatment.
65% said they waited at least 1 business day for prior authorizations; 26% said they waited 3 business days or longer.
36% reported having at least one staff member whose sole purpose was to work on prior authorizations.

The poll also indicated a medical practice completes an average of 31 prior authorization requirements per physician weekly that took the equivalent of almost 2 business days of physician and staff time to complete.

Source:Adobe

“The AMA survey continues to illustrate that poorly designed, opaque prior authorization programs can pose an unreasonable and costly administrative obstacle to patient-centered care,” Jack Resneck, Jr., MD, AMA chair, said in the release.

“The time is now for insurance companies to work with physicians, not against us, to improve and streamline the prior authorization process so that patients are ensured timely access to the evidence-based, quality health care they need,” he added.

Disclosure: Resneck is chair of the AMA.