Prior authorization by the numbers

Prior authorization requirements often hurt physicians' ability to provide care. Here are six key statistics on prior authorization:

1. Thirty-four percent of physicians reported that delays in processing a prior authorization led to a serious adverse event for a patient in their care, according to a survey from the American Medical Association. 

2. Twenty-four percent of physicians reported that a prior authorization delay led to hospitalization of a patient, according to AMA.

3. Eighteen percent of physicians reported that those delays led to a life-threatening event or required intervention to prevent permanent impairment or damage, according to AMA. 

4. Eighty-two percent reported that prior authorization delays can at least sometimes lead to treatment abandonment, according to AMA. 

5.  Seventy-nine percent of medical groups said that payer prior authorization requirements increased in the last year, according to a March poll conducted by the Medical Group Management Association.

6. Thirteen percent of denied prior authorization requests made by Medicare Advantage organizations met Medicare coverage rules, according to a review conducted by the HHS Office of Inspector General. 

 

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