Prior Authorization Delays Care — And Increases Health Care Costs

By Tanya Albert Henry, American Medical Association

Health insurance companies claim prior authorization saves money, but this time-wasting, care delaying tactic may actually add significant costs to the nation’s health system.

In addition to resulting in worse patient care, prior authorization squeezes the pocketbooks of patients, employers, physicians, hospitals and health systems through higher overall use of health care resources, according to the latest results from the AMA’s annual nationwide survey (PDF) of 1,000 practicing physicians about prior authorization.

Nearly 90% of physicians surveyed reported that prior authorization leads to higher overall utilization of health care resources, with nearly half saying that happens “often” or “always.”

Here’s how. According to the physicians queried:

69% reported ineffective initial treatments; for example, due to step-therapy requirements.

68% said prior authorization leads to additional office visits.

42% reported immediate care or emergency department visits.

29% reported hospitalizations.

Read the Article at ama-assn.org