Commercial health plan policies delay patient care, increase burnout: AHA

A new report from the American Hospital Association suggests that private commercial health plans delay patient care and contribute to physician burnout. The paper, which pulls data from a variety of sources, found that commercial insurance policies, like utilization management tools and prior authorization requirements, create significant barriers to patient care and unnecessarily spike administrative costs – while at the same time commercial insurance premiums have been steadily growing above the rate of inflation. Prices are up some 47% in the last 11 years.

Prior authorization requires physicians to submit their anticipated treatment plan to insurers and receive approval before they can move forward. Notably, not all treatments which have received prior authorizations will be covered by insurance. According to a previous study noted in the AHA report, physicians and staff spend as much as two days a week doing prior authorizations, a resource-intensive process, which contributes to physician burnout.

At the same time, prior authorizations can delay patient care, or even lead patients to switch treatment plans entirely. Around 82% of doctors say that the prior authorization process has motivated their patients to drop anticipated treatment plans.