Improving Prior Authorization in Medicare Advantage-Reference-Cited by-同舟云学术

Improving Prior Authorization in Medicare Advantage

Published:2022-10-18 Issue:15 Volume:328 Page:1497
ISSN:0098-7484
Container-title:JAMA
language:en
Short-container-title:JAMA

Author:

Anderson Kelly E.¹²,Darden Michael³⁴,Jain Amit²⁵

Affiliation:

1. Anschutz Medical Campus, University of Colorado, Aurora

2. Hopkins Business of Health Initiative, Johns Hopkins University, Baltimore, Maryland

3. Carey Business School, Johns Hopkins University, Baltimore, Maryland

4. National Bureau of Economic Research, Cambridge, Massachusetts

5. School of Medicine, Johns Hopkins University, Baltimore, Maryland

Abstract

This Viewpoint discusses the potential benefits and harms of prior authorization in Medicare Advantage and the health policy implications and opportunities for improvement.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Link

https://jamanetwork.com/journals/jama/articlepdf/2797197/jama_anderson_2022_vp_220108_1665434188.65456.pdf

Reference9 articles.

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2. Prescription drug coverage for treatment of low back pain among US Medicaid, Medicare Advantage, and commercial insurers.;Lin;JAMA Netw Open,2018

3. The impact of commercial health plan prior authorization programs on the utilization of services for low back pain.;Goodman;Spine (Phila Pa 1976),2016

4. Freed? M, Biniek? JF, Damico? A, Neuman? T; Kaiser Family Foundation. Medicare Advantage in 2022: premiums, out-of-pocket limits, cost sharing, supplemental benefits, prior authorization, and star ratings. Published August 25, 2022. Accessed September 27, 2022. https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2022-premiums-out-of-pocket-limits-cost-sharing-supplemental-benefits-prior-authorization-and-star-ratings/

5. AHIP.org. Prior authorization: selectively used and evidence-based: results of an industry survey. Accessed September 27, 2022. https://www.ahip.org/documents/Prior_Authorization_Survey_Infographic.pdf

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1. Trends in Post-Acute Care use in Medicare Advantage Versus Traditional Medicare: A Retrospective Cohort Analysis;Journal of the American Medical Directors Association;2024-10

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3. 2020 CMS prior authorization for hospital outpatient departments: Associated surgical volume impact;Surgery;2024-08

4. White Paper: American Gastroenterological Association Position Statement: The Future of IBD Care in the United States–Removing Barriers and Embracing Opportunities;Clinical Gastroenterology and Hepatology;2024-05

5. Comparison of prior authorization across insurers: cross sectional evidence from Medicare Advantage;BMJ;2024-03-07