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The extent and growth of prior authorization in Medicare Advantage.
Neprash, Hannah T; Mulcahy, John F; Golberstein, Ezra.
Afiliación
  • Neprash HT; Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware St SE, MMC 729, Minneapolis, MN 55455. Email: hneprash@umn.edu.
Am J Manag Care ; 30(3): e85-e92, 2024 03 01.
Article en En | MEDLINE | ID: mdl-38457827
ABSTRACT

OBJECTIVES:

To assess trends in the use of prior authorization requirements among Medicare Advantage (MA) plans. STUDY

DESIGN:

Descriptive quantitative analysis.

METHODS:

Data were from the CMS MA benefit and enrollment files for 2009-2019, supplemented with area-level data on demographic and provider market characteristics. For each service category, we calculated the annual share of MA enrollees in plans requiring at least some prior authorization and plotted trends over time. We mapped the county-level share of MA enrollees exposed to prior authorization in 2009 vs 2019. We quantified the association between local share of MA enrollees exposed to prior authorization and characteristics of that county in the same year. Finally, we plotted the share of MA enrollees exposed to prior authorization requirements over time for the 6 largest MA carriers.

RESULTS:

From 2009 to 2019, the share of MA enrollees in plans requiring prior authorization for any service remained stable. By service category, the share of MA enrollees exposed to prior authorization ranged from 30.7% (physician specialist services) to 72.2% (durable medical equipment) in 2019, with most service categories requiring prior authorization more often over time. Several area-level demographic and provider market characteristics were associated with prior authorization requirements, but these associations weakened over time. The use of prior authorization varied widely across plans.

CONCLUSIONS:

In 2019, roughly 3 in 4 MA enrollees were in a plan requiring prior authorization. Service-level, area-level, and carrier-level patterns suggest a wide range of approaches to prior authorization requirements.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicare Part C Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Am J Manag Care Asunto de la revista: SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicare Part C Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Am J Manag Care Asunto de la revista: SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos