Literature DB >> 29388035

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

Leah Rand1, Zackary Berger2,3.   

Abstract

We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how at its best, it can contribute to the provision of PCC. PA is a means of cost saving and as such it has mixed success. The example of the US demonstrates how implementation of PA has increased health inequalities whereas best practice has the potential to reduce them. In contrast, systems of universal coverage, like those in Europe, may use the cost savings of PA to better address individuals' care and PCC. The conclusion we offer therefore is an optimistic one, pointing towards areas of supportive overlap between PCC and PA where usually the incongruities are most evident.

Entities:  

Mesh:

Year:  2018        PMID: 29388035     DOI: 10.1007/s40271-018-0299-3

Source DB:  PubMed          Journal:  Patient        ISSN: 1178-1653            Impact factor:   3.883


  13 in total

1.  Medicaid cost control measures aimed at second-generation antipsychotics led to less use of all antipsychotics.

Authors:  William B Vogt; Geoffrey Joyce; Jing Xia; Riad Dirani; George Wan; Dana P Goldman
Journal:  Health Aff (Millwood)       Date:  2011-12       Impact factor: 6.301

2.  Prior-authorization programs for controlling drug spending.

Authors:  Mary Beth Hamel; Arnold M Epstein
Journal:  N Engl J Med       Date:  2004-11-18       Impact factor: 91.245

3.  Insurers' strategies for managing the use and cost of biopharmaceuticals.

Authors:  James C Robinson
Journal:  Health Aff (Millwood)       Date:  2006 Sep-Oct       Impact factor: 6.301

4.  Association between prior authorization for medications and health service use by Medicaid patients with bipolar disorder.

Authors:  Christine Y Lu; Alyce S Adams; Dennis Ross-Degnan; Fang Zhang; Yuting Zhang; Carl Salzman; Stephen B Soumerai
Journal:  Psychiatr Serv       Date:  2011-02       Impact factor: 3.084

Review 5.  Antimicrobial stewardship programs.

Authors:  Kimberly D Leuthner; Gary V Doern
Journal:  J Clin Microbiol       Date:  2013-08-07       Impact factor: 5.948

6.  The values and value of patient-centered care.

Authors:  Ronald M Epstein; Richard L Street
Journal:  Ann Fam Med       Date:  2011 Mar-Apr       Impact factor: 5.166

7.  Prior authorization and overuse of imaging.

Authors:  Grace Hunter; Jennifer Schneider; Sophie Pinkard
Journal:  Health Aff (Millwood)       Date:  2012-12       Impact factor: 6.301

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

Authors:  Christopher P Morley; David J Badolato; John Hickner; John W Epling
Journal:  J Am Board Fam Med       Date:  2013 Jan-Feb       Impact factor: 2.657

9.  Impact of two Medicaid prior-authorization policies on antihypertensive use and costs among Michigan and Indiana residents dually enrolled in Medicaid and Medicare: results of a longitudinal, population-based study.

Authors:  Michael R Law; Christine Y Lu; Stephen B Soumerai; Amy Johnson Graves; Robert F LeCates; Fang Zhang; Dennis Ross-Degnan; Alyce S Adams
Journal:  Clin Ther       Date:  2010-04       Impact factor: 3.393

10.  Patient satisfaction and patient-centered care: necessary but not equal.

Authors:  Joel M Kupfer; Edward U Bond
Journal:  JAMA       Date:  2012-07-11       Impact factor: 56.272

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