Evaluating the effect of prior authorizations in patients with complex dermatologic conditions.
J Am Acad Dermatol
; 83(6): 1674-1680, 2020 Dec.
Article
em En
| MEDLINE
| ID: mdl-32622138
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dermatopatias
/
Tempo para o Tratamento
/
Autorização Prévia
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article