Prior authorization adversely impacts patient care, workforce productivity
Prior authorization (PA) may delay patient access to care, lead patients to abandon recommended treatments, and result in hospitalization, according to new survey results from the American Medical Association.
“Health insurance companies entice employers with claims that prior authorization requirements keep healthcare costs in check, but often these promises obscure the full consequences on an employer’s bottom line or employees’ well-being,” AMA President Gerald Harmon, MD, said in a statement. “Benefit plans with excessive authorization controls create serious problems for employers when delayed, denied or abandoned care harms the health of employees and results in missed work-days, lost productivity and other costs.”
Among the survey’s key findings are:
- 51% of physicians reported that PA had interfered with a patient’s job responsibilities.
- 34% said PA led to a serious adverse event including hospitalization, disability, or even death for a patient in their care.
- 93% reported care delays while waiting for health insurers to authorize necessary care.
- 82% said PA can lead to treatment abandonment.
In addition, 24% of physicians who responded to the survey report that PA has led to a patient’s hospitalization while 18% said it has resulted in a life-threatening event or required intervention to prevent permanent impairment or damage.
Meanwhile, 8% of respondents said that PA has led to a patient’s disability, permanent bodily harm, a birth defect, or death, according to the survey results.
Only 7% of respondents reported that prior authorizations had no impact on patient outcomes.
“Now is the time for employers to demand transparency from health plans on the growing impact of prior authorization programs on the health of their workforce,” said Harmon.
Read the entire survey here.