The insurance industry appears to be making good on its pledge to reduce its use of prior authorization for services and to make that process simpler for providers and patients
Last June, some of the leading health insurers agreed to work to address prior authorization challenges. Now, an AHIP-Blue Cross Blue Shield Association survey has found that they have reduced by 11 percent the number of procedures and services that require prior authorization, which translated into 6.5 million fewer requests.
Medicare Advantage plans went even further, eliminating 15 percent of procedures and services that require prior authorization.
In addition, the insurers report that they are making greater use of electronic prior authorization and implementing additional changes designed to streamline the process and make appealing decisions simpler for consumers.
The participating insurers did not share underlying data to document their assertions.
Learn more about reported improvements in the prior authorization challenge from the Fierce Healthcare article “Insurers have eliminated 11% of prior authorizations under reform pledge” and from this news release from AHIP, a health insurance industry trade group that represents some of the health insurers participating in the effort.