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 >>
Health tech gets focus it long deserved: A discussion with Nora Belcher of the Texas e-Health Alliance
Unintended consequences can be just another part of the territory when it comes to lawmaking. But you can really
The Price Transparency Gas Lighting of America
Price transparency in health care seems pretty straight forward. Bring attention to pricing. Allow patients and competitors to more clearly
TCH-20 Extracting valuable data from the EMR
For a decade, the EMR has been the metaphorical thorn in the side of everyone who works in the hospital
TCH18 – Making Mobile Move for Healthcare and Hospitals
Mobile Smith started making waves for hospitals and health care back when marketing directors around the country were still getting
