The health insurer lobby and trade group conducted an industrywide survey on “prior authorization practices and gold carding experience of commercial plans” between February and April, according to the report. AHIP received responses from 26 plans, covering 122 million commercial enrollees.
Here are four ways payers said they streamline prior authorizations:
Use electronic prior authorizations
88 percent for medical services
75 percent for prescription medications
Waive or reduce prior authorization/step therapy requirements for certain patients
25 percent for medical services
46 percent for prescription medications
Waive or reduce prior authorization requirements based on providers’ participation in risk-based payment contracts
46 percent for medical services
8 percent for prescription medications
Gold carding
58 percent for medical services
21 percent for prescription medications
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