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%).

 

Source Link

Recommended Articles

P4ESC Warns Congress Not to Tax Health Benefits

“We oppose taxing health benefits,” said Neil Trautwein, P4ESC’s Executive Director. “Policymakers will find how widely unpopular the idea will be with Americans with this type of coverage if they take this unwise step,” added Trautwein.

Read More

At Social Security, These Are the Days of the Living Dead

In multiple instances over the past few weeks, Social Security Offices have seen people come in for whom “there is no information on the record, just that they are dead.” So employees have to “resurrect” them — affirm that they’re living, so they can receive their benefits.

Read More

Out-Of-Pocket Drug Spending Hit $98B In 2024: Report

Americans spent $98 billion out of pocket on prescription drugs in 2024, marking a cumulative 25% increase over five years, according to an annual report from analytics firm IQVIA. Why it matters: Lowering prescription drug costs remains a priority for both Democrats and Republicans. The Biden administration led Congress in passing a landmark legislative package to negotiate select drug ...

Read More

Trump Signs Executive Order To Encourage U.S. Drug Manufacturing

U.S. President Donald Trump signed an executive order on Monday that aims to reduce the time it takes to approve pharmaceutical plants in the country, as part of new regulations to encourage domestic manufacturing. The order directs the U.S. Food and Drug Administration to streamline reviews and work with domestic manufacturers to provide early support ...

Read More
arrowcaret-downclosefacebook-squarehamburgerinstagram-squarelinkedin-squarepauseplaytwitter-squareyoutube-square