Black cardiologist group releases prior authorization resource kits for underserved populations

The Association of Black Cardiologists (ABC) announced the issuance of Prior Authorization (PA) Resource Kits designed specifically for cardiologists who work with underserved minority patients. 

The kits were developed to help practices better respond to the administrative needs and improve patient access to appropriate, evidence-based therapies.

A survey conducted by the ABC and the American College of Cardiology (ACC) in February showed prior authorization barriers made it difficult for 42 percent of physicians to receive access to new pharmacologic therapies for their patients—specifically, PCSK9 inhibitors that are prescribed for hyperlipidemia, angiotensin receptor-neprilysin inhibitors (ARNIs) for heart failure and novel anticoagulants (NOACs) for atrial fibrillation (AFib).

The resource kits will provide relevant prior authorization information on lipid disorders, stroke and heart failure, according to a white paper by the ABC. The white paper outlined the unique challenges faced by underserved and minority patients—and how those challenges can negatively impact cardiovascular health outcomes. Generally, access to new treatments for the underserved is hindered by administrative protocols put in place by insurers.

“The need for prior authorization–the approval from an insurer that may be required before patients receive a device, intervention, or medical treatment to be covered by that insurer–for specific drugs focused on cardiovascular care has been a barrier to treatment and a burdensome process for physicians and other providers,” the white paper noted.

The ABC/ACC survey also noted 98 percent of physicians report experiencing a barrier when prescribing new care treatments. About 78 percent of physicians noted cost was the biggest barrier when prescribing new care treatments, and 75 percent said prior authorization documentation and administrative burden was the biggest barrier.

Importantly, 78 percent of physicians believe prior authorization barriers can lead to patients abandoning treatment.

Aside from patient outcomes, a 2017 survey conducted by the American Medical Association (AMA) stated prior authorization protocols impede physician workflow. A total of 84 percent of physicians believe the burden of prior authorization to be high or extremely high.

Additionally, 86 percent of physicians report prior authorization burdens have increased over the past five years. The survey also found a medical practice completes an average of 29 prior authorization-related tasks per physician, which taken an average of 14.6 hours to process. And 34 percent of physicians need staff members to work exclusively on the data entry.

"The practice of medicine is an art, as well as a science," said Keith Ferdinand, MD, Chair of the ABC Access to Care Initiative, which is spearheading the resource kit effort. "Nevertheless, despite advances in evidence-based medications and devices, these new therapies are not applied equally to all, especially considering barriers to access and an often difficult to navigate pre-authorization process."

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As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.

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