A recent Kaiser Family Foundation analysis found an increase in prior authorization requests from 2019 to 2022, along with a rising share of requests that were denied.
Summary
- Prior Authorization Request Increase: More than 46 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2022, up from 37 million in 2019.
- Increasing Denials: In 2022, insurers fully or partially denied 3.4 million (7.4 percent) prior authorization requests. The share of all prior authorization requests that were denied increased from 5.7 percent in 2019 to 7.4 percent in 2022.
- Few Denials Were Appealed: Just one in ten (9.9 percent) prior authorization requests that were denied were appealed in 2022.
- Majority of Appeals Overturned: 2 percent of denials that were appealed resulted in overturned denials.
See what else Groundswell Health is working on in healthcare >>
Hereford Didn’t Have Cardiology. Now It’s a Regional Leader.
Hereford Regional Medical Center HRMC Heart Health Hereford Didn’t Have Cardiology. Now It’s a Regional Leader. Website,
Building Trust as a Strategic Initiative through Leadership at all Levels
Ohio Hospital Association Webinar Features Groundswell Health Leadership Groundswell Health has long been at the forefront of strategic healthcare communications,
The LinkedIn Writing Problem: Why “I’m So Excited” Isn’t a Strategy
Scroll through LinkedIn for five minutes, and you’ll spot the pattern: “I’m so excited to attend [conference]…” “So proud of
The Power of Repeating Themes: Building Influence Through Structured Communication
Hospital leaders face an ongoing challenge of ensuring their organization’s key messages break through the noise and remain top-of-mind
Medicare Advantage Headlines >>
Medicare Advantage Plans Collect $50 Billion Through Home Visits
Becker’s Hospital Review summarized a recently released report from The Wall Street Journal that found Medicare Advantage plans collected $50
2022 OIG report on Denials and Prior Authorization Concerns
A 2022 report from the Office of Inspector General examines the issue of prior authorization denials in Medicare Advantage
