MGMA’s survey includes responses from executives representing 601 group practices, according to the report. The survey was conducted in March.
Six things to know:
1. Forty-six percent of respondents said Medicare Advantage plans were the most burdensome for obtaining prior authorization. Thirty-two percent said commercial plans were the most burdensome, followed by Medicaid (20 percent) and Traditional Medicare (4 percent).
2. Fifty-eight percent of practices saw 15 percent or more of their patients either switch from traditional Medicare to Medicare Advantage, or from one Medicare Advantage plan to another. Eight-four percent of practices said they had to reauthorize existing Medicare-covered services for those Medicare beneficiaries who have switched plans.
3. Sixty percent of practices said there are at least three employees involved in a single prior authorization request.
4. Seventy-seven percent of respondents said their practice has hired or redistributed staff to work on prior authorizations due to an increase in requests.
5. Ninety-seven percent of medical groups reported their patients experience delays or denials for medically necessary care due to prior authorization requirements.
6. Ninety-one percent of respondents said a single stand electronic prior authorization system across all insurers would alleviate burden on their practice.
Read the full report here.
