Dreaded Medical Paperwork Required by Health Insurers to Be Trimmed - WSJ

UnitedHealthcare, Cigna and Aetna move to revamp prior-authorization programs.

The paperwork required by health insurers to get many medical procedures or tests—one of the biggest gripes of doctors and patients—is getting rolled back.

UnitedHealth Group Inc.’s UnitedHealthcare, the largest health insurer in the U.S., said Wednesday it would cut its use of the prior authorization process. Starting in the third quarter, it will remove many procedures and medical devices from its list of services requiring signoff.

I go into a great deal about his issue in my Substack article Dreaded Medical Paperwork Required by Health Insurers to Be Trimmed

For more than two decades patients have heard their physician say I will have to obtain “prior authorization” from your insurance company for this test, drug, or treatment. The paperwork required by health insurers to get many medical procedures or tests—one of the biggest gripes of doctors and patients—is getting rolled back.

This is a major advance in eliminating physician ‘burnout’. Besides the use of electronic health records, many physicians have abandoned their dream of being doctors. Many have said this has become a moral dystopia for providers. For patients, it has meant delays in necessary treatments, causing anxiety, worsening health, and rarely death. It will eliminate stacks of paperwork, and endless waiting on hold to speak to an insurance representative.

Angus Worthing, a rheumatologist in Washington, D.C., whose practice has to employ roughly one prior-authorization-focused staffer for every two doctors, said. Patients typically wait two to four weeks to get medications under the process, he said, and while they wait, he sometimes needs to put them on other drugs that cause side effects. Several decades ago it was presumed that doctors ordered too many tests, and at times treatments that had no evidence for improvement of health. Prior authorizations were thought to decrease these occurrences. Initially, this had the immediate effect to reduce utilization.

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Dreaded Medical Paperwork Required by Health Insurers to Be Trimmed - WSJ: Prior authorization has generated so much resentment in recent years that some health insurers have been making tweaks.