Prior Authorizations Negatively Affect Patient Outcomes

A recent American Medical Association (AMA) survey of 1,000 practicing physicians found that payers' prior authorization requirements delay treatment, have a negative impact on clinical outcomes, and lead patients to abandon treatment. Sixty-four percent reported waiting at least one business day for prior authorization decisions from insurers, and thirty percent said they wait three business days or longer. Every week a medical practice completes an average of 29 prior authorization requirements per physician, which take an average of 14.6 hours to process. The AMA is urging an industry-wide reassessment of prior authorization programs to ensure patients receive timely and medically necessary care and medications and to reduce administrative burdens. Physicians can share their experiences and add their voices to advocacy for reform by going to AMA's Physicians Grassroots Network.