Prior authorization’s impact during COVID-19
Facts at your fingertips
By Emily Margosian, Assistant Editor, October 1, 2021
In December 2020, the American Medical Association (AMA) conducted a survey on the effects of prior authorization (PA) on physicians and patients in their care. The survey was administered to a sample of 1,000 practicing physicians, made up of 40% primary care physicians and 60% specialists. Survey respondents reported that on average, their practices complete 40 PAs per physician, per week, with physicians and their staff spending two business days (16 hours) each week completing PAs.
These survey results reflect physicians’ experiences during a period when COVID-19 cases were surging in the United States (see this month’s feature “Breaking the mold” for more on how COVID-19 has affected patient access to care). While some health plans relaxed their PA requirements to reduce burdens on physicians, over half of survey respondents (52%) reported that requirements were never relaxed, with only 1% reporting at the time of the survey that relaxed requirements were still in place. Visit the AADA’s Practice Management Center for resources on insurance and drug pricing issues, including tools to generate prior authorization and other appeal letters for patients.
For more on the impact of prior authorizations on patient care, see the graphic below.
