Literature DB >> 23288287

The impact of prior authorization requirements on primary care physicians' offices: report of two parallel network studies.

Christopher P Morley1, David J Badolato, John Hickner, John W Epling.   

Abstract

INTRODUCTION: US primary care physicians and their office staff have experienced large increases in time-consuming requirements for prior authorization (PA) of tests, medications, and other clinical services in recent years. This report presents results of 2 similar studies in which physicians and office staff self observed and reported the amount of time spent on PA activities.
METHODS: Physicians and office staff from 12 primary care offices in northeastern United States recorded request type, reporter role, and time spent for each PA event at the time of the PA activity. Costs were estimated using salary data from the US Bureau of Labor Statistics (study 1) and from Salary.com (study 2). Time and costs were estimated for the practices in each study.
RESULTS: The mean annual projected cost per full-time equivalent physician for PA activities ranged from $2,161 (study 1) to $3,430 (study 2). Using self-reporting at the time of the event, we found that preauthorization is a measurable burden on physician and staff time.
CONCLUSIONS: Further studies that include cost-benefit analyses, estimates of opportunity costs and costs of delayed testing and treatment, as well as the "hassle factor" for patients and physicians, are warranted.

Entities:  

Mesh:

Year:  2013        PMID: 23288287     DOI: 10.3122/jabfm.2013.01.120062

Source DB:  PubMed          Journal:  J Am Board Fam Med        ISSN: 1557-2625            Impact factor:   2.657


  6 in total

1.  Pre-authorization processes have no effect on patients undergoing knee MRI in a pediatric setting when evaluated by specialists.

Authors:  Drew Pierce; J Herman Kan; Megan May; George S Bisset
Journal:  Skeletal Radiol       Date:  2016-12-05       Impact factor: 2.199

2.  Prior Authorization as a Potential Support of Patient-Centered Care.

Authors:  Leah Rand; Zackary Berger
Journal:  Patient       Date:  2018-08       Impact factor: 3.883

3.  Realized and Projected Cost-Savings from the Introduction of Generic Imatinib Through Formulary Management in Patients with Chronic Myelogenous Leukemia.

Authors:  David Campbell; Marlo Blazer; Lisa Bloudek; John Brokars; Dinara Makenbaeva
Journal:  Am Health Drug Benefits       Date:  2019-11

4.  The Physician and Administrator-Reported Cost of Drug Utilization Management to Physician Practices: A Cross-Sectional Survey.

Authors:  Marie Louise Edwards; Perry T Yin; Michael Kuehn; Keith Bratti; Noam Kirson; Anupam Jena; Scott Howell
Journal:  Pharmacoecon Open       Date:  2022-07-23

5.  Physician perceptions of drug utilization management: Results of a national survey.

Authors:  Marie Louise Edwards; Perry T Yin; Michael Kuehn; Keith Bratti; Noam Kirson; Anupam B Jena; Scott Howell
Journal:  PLoS One       Date:  2022-09-20       Impact factor: 3.752

6.  Practice characteristics and prior authorization costs: secondary analysis of data collected by SALT-Net in 9 central New York primary care practices.

Authors:  John W Epling; Emily M Mader; Christopher P Morley
Journal:  BMC Health Serv Res       Date:  2014-03-06       Impact factor: 2.655

  6 in total

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