APhA partners with health groups to tackle administrative burdens in prior authorization

Prior authorization process to become more efficient

With an eye toward giving patients access to safe, timely, affordable care, APhA will work with the American Hospital Association, America’s Health Insurance Plans, American Medical Association, Blue Cross Blue Shield Association, and Medical Group Management Association (MGMA) to foster transparency and promote better communication in the prior authorization process.

The partnership released a consensus statement on January 17 outlining the ways its members will strive to lighten the administrative load for health professionals while improving patient care. The organizations in the partnership will focus on five key areas: reducing the number of health professionals subject to prior authorization requirements; reviewing the services and medications that require prior authorization; improving channels of communications between insurance providers, health professionals, and patients; protecting continuity of care for patients; and speeding up the adoption of national electronic standards for prior authorization.

Thomas E. Menighan, executive vice president and CEO of APhA, hailed the partnership’s efforts as a step toward enhancing care delivery.

“We are very supportive of this collaborative effort that is critical to improving patients’ access to needed medical services and medications, promoting continuity of care, and removing provider burdens. Adoption of these principles will free physicians, pharmacists, and others to spend more time in patient care,” Menighan said.

Anders Gilberg, MGA, senior vice president of government affairs at MGMA, stressed the impact of collaboration among the organizations involved.

“By forging an agreement addressing an important set of prior authorization challenges, this collaborative is leading the industry toward the dual aim of reducing the volume of required authorizations and decreasing complexity in conducting these transactions,” Gilberg said.