The burden of prior authorizations: 5 key stats 

Eighty-nine percent of providers said that prior authorizations were very or extremely burdensome, according to the Medical Group Management Association’s 2023 “Regulatory Burden Report.” 

Advertisement

The survey included responses from 350 group practices. Sixty percent are in practices with fewer than 20 physicians and 16% are in practices with more than 100 physicians. 

Here are four more key statistics on the burdens of prior authorization:

1. Ninety percent of respondents said their overall regulatory burden has increased over the last year. 

2. Ninety-seven percent said patients experienced delays or denials for medically necessary care because of prior authorizations. 

3. Ninety-two percent said their practice hired or redistributed staff to work on prior authorizations due to the request increase. 

4. When asked about specific challenges with prior authorizations, 88% cited delays in prior authorization decisions, 80% said inconsistent payer payment policies and 83% said prior authorizations for routinely approved services.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.