AMA Study of Managed Care: It’s Bad
- More than one-third (37%) of physicians experience a 20 percent rejection rate from insurers on first-time preauthorization requests for tests and procedures.
- More than half (57%) of physicians experience a 20 percent rejection rate from insurers on first-time preauthorization requests for drugs.
- Nearly half (46%) of physicians experience difficulty obtaining approval from insurers on 25 percent or more of preauthorization requests for tests and procedures.
More bad news below the fold.
- More than half (58%) of physicians experience difficulty obtaining approval from insurers on 25 percent or more of preauthorization requests for drugs.
- Nearly two-thirds (63%) of physicians typically wait several days to receive preauthorization from an insurer for tests and procedures, while one in eight (13%) wait more than a week.
- More than two-thirds (69%) of physicians typically wait several days to receive preauthorization from an insurer for drugs, while one in ten (10%) wait more than a week.
- Nearly two-thirds (64%) of physicians report it is difficult to determine which test and procedures require preauthorization by insurers.
- More than two-thirds (67%) of physicians report it is difficult to determine which drugs require preauthorization by insurers.
- Physicians spend 20 hours per week on average just dealing with preauthorizations.
Did we need a study/survey to know that managed care is bad?
That’s not “managed care”, that’s the standard sort of nonsense that every insurance plan except Medicare uses to harass physicians.
artk, good to see you back. I’ve missed you.
Managed Care + 30 years = Accountable Care Organizations
What difference does it make whether you call it “managed care” or “harassment”? Isn’t the end result the same? Third party payers pay out less money.
Whatever you call it, it looks pretty bad.
Hard to feel any sympathy for the AMA. Afterall, they went along with Obama Care. Yes they were totally stabbed in the back for their efforts by the Obama White House and the Congressional Democrats. Still, they tried their best to sell the rest of us out for their own pot of porridge.
This is partly why physicians are increasingly becoming employees of hospitals or integrated health plans. Young doctors don’t want the hassle of private practice, where physicians are forced to spend too much time figuring out how to bill insurance companies or which services insurers require prior approval for in to get reimbursed.
Commercial Insurance= a “CMS” that makes better investments…
It seems that healthcare is going down this road of decreased freedom. It just irks me that Berwick and Obama keep touting patient choice and patient empowerment.