Prior authorization practices are a significant problem that cause delays in patient care, according to a new survey of more than 650 practicing radiation oncologists.
The survey, conducted by the American Society of Radiation Oncology (ASTRO), was completed by respondents between December 2018 and February 2019.
These are some of the survey’s key findings regarding prior authorization and patient care:
- A whopping 93% of respondents said their patients have experienced delayed treatment as a result of prior authorization, and 31% said that the delay was longer than five days.
- While 73% of respondents said their patients express concern about their care being delayed due to prior authorization, 32% have had to use alternate therapies for “a substantial number of their patients” due to those delays.
- A majority of denials are ultimately overturned on appeal, according to 62% of respondents.
“This survey makes clear that restrictive prior authorization practices can cause unnecessary, stressful and potentially life-threatening delays for cancer patients,” Paul Harari, MD, chair of the ASTRO Board of Directors and a professor at the University of Wisconsin-Madison, said in a prepared statement. “While the system may have been designed as a path to streamline and strengthen health care, it is in fact frequently harmful to patients receiving radiation therapy. In its current form, prior authorization causes immense anxiety and wastes precious time for cancer patients.”
“Radiation oncology and cancer patients have been particularly hard hit by prior authorization’s unnecessary burden and interference in care decisions,” Vivek Kavadi, MD, vice chair of ASTRO’s Payer Relations Subcommittee and a radiation oncologist for Texas Oncology, said in the same statement. “Radiation oncologists increasingly are restricted from exercising our clinical judgment in what is in the best interest of the patient, yet we are held accountable for the outcomes of treatments where decisions have been taken out of our hands.”