The agreement —outlined in a consensus statement from the American Hospital Association, America’s Health Insurance Plans, American Medical Association, American Pharmacists Association, Blue Cross Blue Shield Association and Medical Group Management Association — ultimately aims to streamline prior authorization, thereby reducing the administrative burden on providers and improving patients’ access to timely care, according to the organizations.
As part of the agreement, the organizations said they would join forces to decrease the number of healthcare professionals required to comply with prior authorization rules “based on their performance, adherence to evidence-based medical practices, or participation in a value-based agreement with the health insurance provider,” according to a news release. They also agreed to improve communication regarding prior authorizations between insurers, healthcare professionals and patients, as well as “regularly review the services and medications that require prior authorization and eliminate requirements for therapies that no longer warrant them.”
To read more about the consensus statement and comments from each individual organization, click here.
More articles on leadership and management:
Michael Dowling: The prizes and pitfalls of hospital acquisitions
House GOP stopgap bill includes 6 years of funding for CHIP, delay for taxes: 4 things to know
Trios to lay off 9 employees in latest cost-cutting move
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.