Prior authorization (PA) has long been recognized for its ability to help payers manage prescription coverage while ensuring appropriate, safe treatment for patients.
While a necessary component of the healthcare industry, PA is often cited as one of the top burdens for healthcare professionals. In fact, the average burden reported by providers around PA is a combined 7.7 on a 10-point scale.1
“I spend hours on the phone, especially after the New Year. It’s so very time consuming when I could be working on more important things such as stat appointments or vitals.”
― Health care provider
Beyond causing frustration for pharmacists, providers and their staff, the perception of PA negatively impacts relationships between stakeholders in the industry. Providers associate a poor PA experience with payers, and often change their prescribing behavior, potentially impacting patient health outcomes, to avoid the PA process. That being said, providers and payers want to work together to make this process easier for all stakeholders, and find solutions which will benefit the patient.2
Ultimately, the patient – arguably the most important customer for payers, providers, pharmacists and manufacturers – bears the brunt of the PA process through delayed treatment or prescription abandonment.
In this article, we’ll take a deeper look at the factors that cause PA to be perceived negatively by providers, and how industry stakeholders can improve the process with an ePA solution. By doing so we allow physicians and their staff to focus on treating patients and improving medication adherence.