Here are five numbers illustrating the effect prior authorization regulations and reform efforts have on healthcare:
97%: The percentage of providers who have had delays or denials for necessary patient care due to prior authorization requirements, according to the Medical Group Management Association's 2023 "Regulatory Burden Report."
9: The number of states that updated laws or passed new ones in 2023 that shifted prior authorization rules, according to a March 8 article posted on the American Medical Association's website.
$15 billion: The amount recent prior authorization reforms are expected to save physician practices over the next 10 years, according to Jesse Ehrenfeld, MD, president of the American Medical Association.
16%: The percentage prior authorization denials for outpatient care claims jumped in the last three years.
$19.7 billion: The approximate amount hospitals and health systems spend every year pursuing reconsiderations of previously denied claims.