作者
Mitchell A Psotka, Elizabeth A Singletary, William K Bleser, Rachel A Roiland, Marianne Hamilton Lopez, Robert S Saunders, Tracy Y Wang, Mark B McClellan, Nancy Brown, American Heart Association Prior Authorization Learning Collaborative*
发表日期
2020/7
期刊
Circulation: Cardiovascular Quality and Outcomes
卷号
13
期号
7
页码范围
e006564
出版商
Lippincott Williams & Wilkins
简介
Utilization management strategies, including prior authorization, are commonly used to facilitate safe and guideline-adherent provision of new, individualized, and potentially costly cardiovascular therapies. However, as currently deployed, these approaches encumber multiple stakeholders. Patients are discouraged by barriers to appropriate access; clinicians are frustrated by the time, money, and resources required for prior authorizations, the frequent rejections, and the perception of being excluded from the decision-making process; and payers are weary of the intensive effort to design and administer increasingly complex prior authorization systems to balance value and appropriate use of these treatments. These issues highlight an opportunity to collectively reimagine utilization management as a transparent and collaborative system. This would benefit the entire healthcare ecosystem, especially in light of the …
引用总数
20202021202220232024271255