Physician frustration with prior authorizations only grows

Female nurse looking stressed
Increasing prior authorization requests from payers is a major pain point for doctors.

Doctors are fed up with prior authorizations from health insurance companies, according to two physician organizations.

The American Academy of Family Physicians (AAFP) said that frustration has reached an all-time high as it and the Medical Group Management Association (MGMA) try to rein in those requests from insurance companies.

Less than a week after the AAFP unveiled a new policy on prior authorizations, the MGMA released a poll that showed the problem has only increased.

The MGMA Stat poll revealed that 86% of respondents reported that prior authorization requests, as well as other requests from health insurers asking for physicians to provide supporting documentation on patients, had increased in the past year.

 

Eleven percent of the roughly 1,000 medical practice leaders who responded to the poll said the number stayed the same and only 3% said requests decreased. That was a 4% increased from 2016.

"Health plan demands for prior approval for physician-ordered medical tests, clinical procedures, medications and medical devices ceaselessly question the judgement of physicians, resulting in less time to treat patients and needlessly driving up administrative costs for medical groups," MGMA President and CEO Halee Fischer-Wright, M.D., said in an announcement about the poll results.

The AAFP said its policy raises the same objections. "The very manual, time-consuming processes used in prior authorization programs burden family physicians, divert valuable resources away from direct patient care and can inadvertently lead to negative patient outcomes,” the policy said.

Both groups were part of a 17-member coalition that put together 21 principles earlier this year pushing for for insurers to reform prior authorization processes to approve medical tests, procedures, devices and drugs for patients. It urged health plans, benefit managers and others to reform current requirements, and released the principles it says would improve timely access to care and reduce administrative burdens.

RELATED: Physicians: 5 ways insurers could make life easier

When asked about their major pain points in dealing with payers, nearly 1,100 doctors from across the country suggested insurers could make authorizations easier by letting office staff handle them.