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The majority of physicians report treatment delays due to prior authorization



Ninety-four percent of physicians report care delays related to insurance requirements for prior authorization and 80% report that such prior treatment approvals have led to early treatment abandonment, according to the results of a survey released Monday by the American Medical Association.

The survey of 1,001 physicians conducted in December 2022 also found that 31% of physicians report that prior authorization criteria — many of which are in place because of state regulations or parameters set by individual insurers — are “rarely or never evidence-based.”

In terms of effectiveness, 33% of physicians report that prior authorization has led to “a serious adverse event”

; for a patient in their care, and 9% report that it has led to “permanent bodily harm/disability or death.”

Eighty-six percent of respondents said prior authorization leads to higher overall utilization of health care resources and 64% said authorization requests have led to “inefficient” initial treatments.

On average, physicians handle 45 prior authorization requests per week and reportedly spend two business days each week handling such requests; 35% state that they have had to hire additional staff just to handle administrative tasks related to such requests.


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