Prior Authorization is Putting Patients at Risk and
Increasing Physician Burden
Patient Access to Care Has Been Adversely Impacted
Nearly all respondents state that prior authorization causes delays in access to necessary care, and the wait
time for prior authorization can be lengthy. For most physicians (74%) it takes between 2 to 14 days to
obtain prior authorization, but for 15%, this process can take from 15 to more than 31 days.
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A majority of physicians reported that prior authorization causes patients to abandon treatment altogether.
Similarly, three-quarters (74%) of respondents reported that during the past five years, stable patients had
been asked to switch medications by the health plan even though there was no medical reason to do so.
Overwhelmingly (87%), physicians report that prior authorization has a negative impact on patient clinical
outcomes.
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The Burden of Prior Authorization on Physicians Has Increased
Most physicians (84%) report that the burden associated with prior authorization has significantly
increased over the past five years as insurers have increased the use of prior authorization for procedures
(84%); for diagnostic tools (78%); and for prescription medications (80%). The burden associated with
prior authorization for physicians and their staff is now high or extremely high (92%).
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