Blue Cross and Blue Shield of Rhode Island is eliminating nearly 65% of prior authorization requirements for primary care providers by early 2025.
BCBSRI reviewed data to identify some of the most common orders that create additional work for PCPs. Radiology and cardiology services lead the list of requirements being cut, and the changes will apply across commercial and Medicare plans, according to a June 27 news release.
"We're hopeful that reducing these authorizations, along with our significant investments in primary care practices, will help PCPs thrive and improve patient access to care as we continue to strive for balance between affordability for Rhode Islanders and stability for providers," BCBSRI President and CEO Martha Wofford said.
BCBSRI removed all prior authorization for outpatient behavioral services in 2018. Other payers such as UnitedHealthcare, Cigna, BCBS Michigan, Point32Health and Aetna have all reduced prior authorization requirements recently.