Payers drag feet on prior authorization reform, physicians say

The majority of health plans aren't "making meaningful progress" on prior authorization reforms, according to a physician survey released by the American Medical Association.

The survey took place in December 2018 and included responses from 1,000 physicians on their experience with prior authorization.

Five key takeaways from the survey:

1. Just 8 percent of physicians said they work with a health plan that allows some providers to be exempt from prior authorization requirements.

2. Phone and fax are still the most commonly used methods for prior authorization, according to the physicians. Only 21 percent of physicians said their EHR system completes electronic prior authorization for prescription medications.

3. Most physicians (88 percent) said the number of drugs that require prior authorization has increased. Eighty-six percent said the same about the number of services requiring prior approval.

4. Nearly 7 in 10 physicians said they find it difficult to determine if a prescription or medical service requires prior authorization.

5. Eighty-five percent of physicians said prior approval processes interfere with care continuity.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months