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引用次数: 0
摘要
这篇评论讨论了当前的事先授权(PA)流程及其对患者护理的负面影响。根据美国医学协会(American Medical Association)的数据,94%的患者在治疗中遇到延误,78%的患者完全放弃治疗。这些护理延误往往是为了挽救生命的治疗,并可能导致不良事件。此外,PAs给患者和提供者带来了广泛的行政和经济负担,通常需要几个小时寻求保险公司的批准,或者要求患者尝试一种或多种其他治疗途径,然后保险公司才会批准原来的治疗方案。与此同时,保险公司每年都在创造创纪录的利润。对这一制度的不满导致越来越多的医生转向只收现金的商业模式,这种模式增加了自主权,使价格透明,并使医生和病人都受益。
Prior authorizations and the adverse impact on continuity of care.
This commentary discusses the current prior authorization (PA) process and the negative impacts it can have on patient care. According to the American Medical Association, 94% of patients experience delays in care and 78% abandon treatment altogether. These delays in care are often for lifesaving treatments and can result in adverse events. Additionally, PAs place an extensive administrative and financial burden on both patients and providers, often requiring several hours of seeking approval from insurance companies or requiring patients to try one or more other therapeutic avenues before an insurance company will approve the original course of treatment. This is all while insurance companies are making record profits each year. Frustrations with this system are leading to a rise in the number of physician practices switching to a cash-only business model, which increases autonomy, enables price transparency, and benefits both physicians and patients.
期刊介绍:
The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers, and other healthcare professionals. Its aim is to stimulate scientific communication in the ever-evolving field of managed care. The American Journal of Managed Care addresses a broad range of issues relevant to clinical decision making in a cost-constrained environment and examines the impact of clinical, management, and policy interventions and programs on healthcare and economic outcomes.