Prior Authorizations Are Top Burden For Medical Groups: MGMA

Prior authorization is the most burdensome regulatory issue facing medical groups, with 89% saying it is very or extremely burdensome, according to a Nov. 13 report from the Medical Group Management Association.

The MGMA’s annual regulatory report surveyed executives from more than 350 group practices, according to the report. Sixty percent of respondents are in practices with fewer than 20 physicians and 16 percent are in practices with more than 100 physicians. Seventy-five percent of respondents are in independent practices.

According to the report, 97 percent of leaders surveyed said their patients have experienced delays or denials for medically necessary care due to prior authorization requirements. Ninety-two percent said their practice has hired or redistributed staff to work on prior authorizations due to the increase in requests.

Leaders said the top challenges are delays in prior authorization decisions (88%), prior authorizations for routinely approved items and services (83%), and inconsistent payer payment policies (80%).


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