The top 5 barriers to automated prior authorization according to payers

Providers using EHRs that aren't enabled for electronic prior authorization and the cost to upgrade to EHRs that have that capability are the main barriers preventing automated PA, according to a Nov. 14 America's Health Insurance Plans survey

The health insurance 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 a total of 122 million commercial enrollees.

Top barriers to automated prior authorization:

  1. Provider does not use EHR enabled for electronic PA: 71 percent

  2. Costly/burdensome for providers to buy/upgrade EHR for electronic PA: 71 percent

  3. Lack of interoperability between EHR vendors: 62 percent

  4. Costly for payers to enable PA rules and information to be delivered electronically: 43 percent

  5. Lack of electronic PA solutions on market: 19 percent


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