57% of experienced users said electronic prior authorization made it easier to understand the requirements for prior authorization.
54% of experienced users said electronic prior authorization made it easier to view the prior authorization decision.
Greatest benefit for providers who use technology for most or all their patients
The more frequently a provider used the technology solution, the bigger the benefit the provider experienced in reduced burden and ease of understanding prior authorization information
“The review of over 40,000 transactions showed the impact electronic prior authorization makes in health care,” said Denise H. Clayton, PhD, Research Economist, Health Economics and Evaluation at RTI International. “Because clinicians and their staff report more benefits from ePA when they use it more often, greater provider adoption of ePA could help further realize its promise.”
“ePA has shown that it can reduce burden on providers and streamline care for patients,” Berry said. “Health insurance providers are committed to using proven technologies like ePA to improve patient care and provider experience.”

“The findings of this pilot are profound in terms of reduced time-to-therapy leading to improved patient care among other benefits,” said Tony Schueth, CEO & Managing Partner of Point-of-Care Partners, expert advisors to the project. “At the same time, they are consistent with other studies we have done in showing a wide variance in the proportion of prior authorization requests still not being submitted or responded to electronically. Therefore, there is still a significant upside to ePA that should lead to all stakeholders wanting to come together to make it work.”

“Medication only works if patients can access, afford and adhere to it,” said Mike Pritts, Chief Product Officer, Surescripts. “By working together across the industry to drive greater use of electronic prior authorization, we can eliminate phone calls and faxes, get patients started on treatment faster, and improve overall care by increasing medication adherence.”


About AHIP
AHIP is the national association whose members provide coverage for health care and related services to hundreds of millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access, and well-being for consumers.

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