Doctors in the United States deal with a long and complex process called prior authorization set by health insurers. Before giving certain medicines, tests, or treatments, they must get approval from the insurer to make sure it will be paid for. The goal is to stop unnecessary care and keep costs down. But this often causes a lot of extra work for medical offices.<\/p>\n
The American Medical Association (AMA) did a survey in 2022. It showed that 86% of doctors said they used more health resources because of prior authorization. Instead of saving money, it created extra work and waste. Doctors and their staff handle about 45 prior authorizations every week. They spend about 14 hours just on this task. It costs medical offices between $2,161 and $3,430 per year for each full-time doctor to manage the paperwork and follow-ups.<\/p>\n
For managers in medical clinics, these numbers show a real strain on their resources. Staff who should help patients may spend all their time on prior authorizations. This takes workers away from tasks like scheduling appointments, managing money, or helping with care. This makes running a clinic harder and less efficient.<\/p>\n
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The delays caused by prior authorization have serious effects beyond just paperwork. The AMA found that 94% of doctors said prior authorization made patient care slower. These delays can frustrate patients. About 80% of doctors said some patients stopped their suggested treatment because of these delays. Stopping treatment can make health problems worse and cause trouble managing long-term illnesses.<\/p>\n
Also, delays linked to prior authorization can cause serious problems for patients. One-third of doctors said they saw cases where prior authorization led to bad results. Of those, 25% needed hospital care because of delayed treatment. For clinic managers and IT staff who handle patient safety and records, these numbers show the need for faster and better ways to work.<\/p>\n
The American College of Physicians (ACP) is worried about these problems. They want changes to reduce these burdens that get in the way of patient care. Almost 90% of doctors see prior authorization as a negative factor for patient health results.<\/p>\n
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