1 in 4 physicians say prior authorization delays have caused a hospitalization

More than 90 percent of physicians reported that prior authorization delays care, and nearly one-fourth say those delays have led to patient hospitalizations, according to a Feb. 10 American Medical Association survey

The association surveyed 1,004 physicians — both primary care physicians and specialists — in December on the effects of prior authorizations on patient care. 

7 insights:

1. While 93 percent of physicians reported that prior authorization leads to delays, 56 percent said there are "often" or "always" delays delivering necessary care. 

2. Eighty-two percent of respondents said the threat of delays can at least sometimes lead to abandoning a type of treatment. 

3. More than one-third of physicians said prior authorization has caused a "serious adverse event" for a patient, with about one-fourth saying it has led to a hospitalization. 

4. While the majority of physicians said prior authorizations are rooted in peer-reviewed research, 30 percent said they "rarely" or "never" are. 

5. An overwhelming majority (91 percent) of physicians said prior authorizations negatively affect patients, with 7 percent saying it has no effect on clinical outcomes. Only 1 percent said they positively affect outcomes. 

6. Physicians and supporting staff spend the equivalent of nearly two business days, or 13 hours, completing prior authorizations. Eighty-eight percent of physicians say the burden of completing these requests is "high" or "extremely high."

7. More than half (51 percent) of physicians said a prior authorization has interfered with a patient's ability to work. 

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