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[The following is a paid advertisement.]
Getting needed care for any health issue is best done sooner than later. For patients insured through Medicaid managed care organizations (MCOs), preauthorization denials are all too common. These inappropriate denials delay care, leading to poorer health outcomes while reducing MCO costs and increasing shareholder profits.
The prior authorization processes of MCOs are inconsistent and complex. One Illinois MCO had a 41% denial rate while another denied 15% of prior authorization requests, the U.S. Dept. of Health and Human Services Office of Inspector General (OIG) found.
What’s more, MCO’s self-report scattered outcomes from the appeals process, which requires countless hours of physicians and hospital staff. One Illinois MCO reported overturning 57% of denied prior authorization requests. Another said it overturns 63% of denied prior authorization requests on appeal.
What would prior authorization reform mean for patients? It would mean living fuller, healthier lives without unnecessary time away from work, school or family responsibilities. It would mean less stress, better health outcomes and a more productive future.
The Illinois hospital community urges legislators to pass commonsense legislation to streamline access to care and improve health outcomes by eliminating inappropriate prior authorization practices and embracing care coordination. Support IHA’s MCO prior authorization reforms.
posted by Advertising Department
Tuesday, May 14, 24 @ 1:52 am
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