Evaluating the effect of prior authorizations in patients with complex dermatologic conditions - 09/11/20
Abstract |
Background |
In dermatology, prior authorizations can delay treatment, decrease patient adherence, and deter providers from advocating for their patients. Patients with complex dermatologic conditions, often requiring off-label treatments, may face particularly significant insurance barriers.
Objective |
Evaluate the effect of prior authorizations in patients with complex dermatologic conditions.
Methods |
This prospective cohort study assessed patients treated by a dermatologist during 5 months who specialized in complex dermatology. Patients included were older than 18 years, treated at V.P.W.'s rheumatology-dermatology clinic, and prescribed a medication or ordered a diagnostic procedure that elicited an insurance prior authorization. Data on prior authorization outcome, administrative time, and delay to treatment were collected.
Results |
Of 51 prior authorizations, 51% were initially denied, with systemic medications more likely denied than topical ones (P < .001). Total administrative time spent on 50 prior authorizations tracked was 62.5 hours (median time per prior authorization 30 minutes [interquartile range 17-105 minutes]). Time to access treatment was tracked for 80% of prior authorizations; median delay was 12 days [interquartile range 5.5-23 days].
Limitations |
Single-center, single-provider patient panel.
Conclusion |
Patients with complex dermatologic conditions face a significant barrier to care because of prior authorizations. The administrative burden for provider practices to address these prior authorizations is substantial and may warrant a streamlined system in collaboration with insurers.
Le texte complet de cet article est disponible en PDF.Key words : complex medical dermatology, health care delivery, prior authorizations
Plan
| Funding sources: This work was supported by the U.S. Department of Veterans Affairs (Veterans Health Administration, Office of Research and Development and Biomedical Laboratory Research and Development), the National Institutes of Health (R01AR071653 to Dr Werth), and National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award T32-AR-007465. Dr Barbieri receives partial salary support through a Pfizer Fellowship grant to the Trustees of the University of Pennsylvania. |
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| Conflicts of interest: None disclosed. |
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| The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. |
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| Reprints not available from the authors. |
Vol 83 - N° 6
P. 1674-1680 - décembre 2020 Retour au numéro
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