Survey indicates Prior Authorization for imaging causes anxiety for cancer patients

A new study published in JAMA Network Open reveals the negative impact of prior authorization on cancer patients’ care and well-being. The study, conducted by researchers from Memorial Sloan Kettering (MSK), surveyed 178 cancer patients who had experienced prior authorization for various services, such as imaging, chemotherapy, surgery, and radiotherapy.

Key findings

• 69% of the patients reported a delay in care due to prior authorization, with 73% of them waiting more than two weeks.
• 22% of the patients did not receive the care recommended by their treatment team because of PA.
• 67% of the patients had to become personally involved in the prior authorization process, and 20% spent more than 11 hours on it.
• 40% of the patients rated their experience with prior authorization as “bad” and 32% as “horrible”.
• Prior authorization-related anxiety was higher than typical scores and correlated with delay length, time spent on prior authorization, and overall experience.
• 89% of the patients trusted their insurance company less and 83% trusted the healthcare system less after dealing with prior authorization.

Implications

The study authors concluded that prior authorization is a source of anxiety and administrative burden for cancer patients, and may compromise the quality of care and patient satisfaction. They called for policy interventions and advocacy efforts to reform the prior authorization process and improve the patient experience.

They also noted that this is the first study to ask oncology patients about their experience with prior authorizations, and that understanding the patient perspective is vital for refining the utilization management process.