(Nov. 17, 2023) – Prior Authorization reform is an important policy priority for the Kansas Hospital Association and our members. We recognize the administrative burden that is created by the prior authorization process. We also understand how prior authorization restrictions impact patient care and can cause unnecessary delays. In preparation for the upcoming legislative session, KHA has produced two prior authorization podcasts that delve deeper into the unreasonable requirements, variations in submission processes and inappropriate denials coming from some insurance payers.
KHA previously conducted a survey to better understand the impact of the prior authorization process on Kansas hospitals. The survey results corroborated what we have long heard from the health care community. More than 55 percent of Kansas hospitals reported the prior authorization process often resulted in unnecessary delays in patient care. This result is similar to the findings from the American Medical Association, which found that 80 percent of physicians reported prior authorization can sometimes lead to treatment abandonment. To help explain the impact of the prior authorization process, KHA has produced a new infographic that we shared with the membership yesterday at the Rural Health Symposium. Our team is working on additional resources to help members when discussing prior authorization reform with policymakers, including talking points and template opinion editorials.
Along with producing materials to help hospital leaders address the topic of prior authorization with policymakers and the public, KHA is implementing an All Payers Scorecard. The scorecard provides measurable data demonstrating the insurance challenges some hospitals encounter and gives KHA factual statistics to articulate the current hospital/payer environment. The results of the All Payers Scorecard also may serve as a tool to aid in the state policy arena, if necessary.
Hospitals, providers and patients deserve a sensible prior authorization system that doesn't inhibit access to efficient and appropriate health care services. KHA will continue to advocate on behalf of the KHA membership for prior authorization reform, including on the state level. Most recently, through the efforts of KHA and the membership, the new Medicaid request for proposal included a majority of our recommendations to improve prior authorization processes within the Medicaid program. While this is only one payer, we are committed to seeing improvements among all payers, commercial or private. We recognize that a process that achieves a balanced approach among health care providers and insurers will likely result in better patient care, which should be the ultimate goal of everyone involved.
--Chad Austin