What’s it Going to Take to Fix Healthcare’s Chronic Prior Authorization Pain?

In a discussion on fixing healthcare’s prior authorization issues, experts Shereese Maynard and Colin Banas highlighted its critical yet contentious nature. Maynard noted that the current process often increases costs by denying timely care, exacerbating patients’ conditions, especially in Medicaid. Banas shared that 90% of physicians see prior authorization negatively impacting treatment, with a quarter witnessing adverse events like unnecessary hospitalizations. Solutions include reducing unnecessary prior authorizations, leveraging AI for automation, and implementing “gold carding” for specialists with good track records. Both experts emphasize the need for consistency, transparency, and better technology to streamline prior authorizations, reduce bureaucracy, and improve patient outcomes.