Prior Authorizations and the Adverse Impact on Continuity of Care

This commentary discusses the current prior authorization (PA) process and the negative impacts it can have on patient care. According to the American Medical Association, 94% of patients experience delays in care and 78% abandon treatment altogether. These delays in care are often for lifesaving treatments and can result in adverse events. Additionally, PAs place an extensive administrative and financial burden on both patients and providers, often requiring several hours of seeking approval from insurance companies or requiring patients to try one or more other therapeutic avenues before an insurance company will approve the original course of treatment. This is all while insurance companies are making record profits each year. Frustrations with this system are leading to a rise in the number of physician practices switching to a cash-only business model, which increases autonomy, enables price transparency, and benefits both physicians and patients.