Prior authorizations lead to delays in retina care: Study

The majority of prior authorizations for ophthalmology patients seeking anti-vascular endothelial growth factor medications have been linked to delays in care, according to a June 27 study published in JAMA Ophthalmology. 

The study looked at nine retina practices and 2,225 prior authorization requests across the U.S., finding that 96% of prior authorizations for medications were approved. 

The prior authorizations were also associated with a delay in care, and each authorization required a median of 100 minutes of clinic staff time. 

Anti-vascular endothelial growth factor intravitreal injections are a mainstay of treatment for many retinal diseases to optimize visual outcomes. 

Of the 2,140 prior authorization approvals, 59.6% resulted in a delay in care greater than 24 hours, and 40% were given on the date of service.

Of the delayed approvals, 23.9% were approved within one day, 15.9% were approved within two to three days, 21.5% were approved within four to seven days, 26.3% were approved within eight to 31 days and 12.4% were approved within more than 31 days.

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