Poll Shows Physician Frustration with Prior Authorizations at New High

The topic of prior authorizations is heating up as physicians and the medical organizations that represent them attempt to rein in such requests from health insurance companies. The Medical Group Management Association recently released polling results that reveal the extent of the problem. In a recent poll, 86% of respondents said that prior authorization requests and other requests for supporting documentation on patients had increased in the past year. Of the 1,041 applicable responses from medical practice leaders around the country, just 3% said such requests were decreasing, and 11% said the number of requests was about the same as in 2016. The polling results came less than a week after the American Academy of Family Physicians (AAFP) unveiled its new policy on prior authorizations, which objects to the “time-consuming processes [that] burden family physicians, divert valuable resources away from direct patient care, and can inadvertently lead to negative patient outcomes.” For more information, go to https://www.aafp.org/news/practice-professional-issues/20170609priorauth.html.

Family Physicians Offer Perspectives on Incarceration and Health

The AAFP has released a position paper that focuses on the health impact incarceration has on inmates and their families. Inmates in correctional facilities are more likely than members of the general population to have infectious disease, mental health problems, and substance use and addiction disorders, and these facilities are often ill-equipped to provide for the medically underserved. The paper highlighted five things family physicians can do to help with issues surrounding incarceration and its effects on patients: learn about the unique needs of incarcerated or formerly incarcerated individuals and their families; consider working in the prison system or volunteering to work with individuals during or after their incarceration; advocate that prisoners, former prisoners, and their families have adequate access to mental health and substance abuse treatment services; advocate that unnecessary jail and prison stays be prevented by diverting eligible persons to substance abuse and/or mental health treatment; and work with legislators on other policy issues related to prisoner health. For more information, go to https://www.aafp.org/news/practice-professional-issues/20170612incarceration.html.

Researchers Examine Exemplary Approaches to Team-Based Care

The average Medicare patient sees seven physicians across four different practices, and 75% of those who are admitted to the hospital cannot identify the physician responsible for their care. These factors contribute to $130 billion wasted because of ineffective health service delivery. However, some coordinated care initiatives are working to combat these statistics. Researchers at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care recently profiled four Medicare Advantage practices that exemplify a coordinated approach to providing primary care and support services. Each plan cited in the report cares for a distinct patient panel, but they all targeted a specific demographic or desired outcome, and they all relied on coordination with allied health professionals to assist patients with essential health tasks that often cannot be addressed during an office visit. The authors also found common barriers to wider adoption of effective solutions: technology gaps and inconsistent payment. The authors emphasized that exemplary care management requires ongoing evaluation of more than just a patient's physical health needs. For more information, go to https://www.aafp.org/news/practice-professional-issues/20170616medicareadvantage.html.

CBO Projects Rising Demand for Primary Care Physicians

The demand for primary care physicians will rise at a steady pace as the U.S. population expands and grows older, and state and federal lawmakers should consider options to boost their ranks, according to a recent report from the Congressional Budget Office (CBO). In 2023, demand for services provided by primary care physicians is expected to be 18% higher than 2013 levels, largely because of population growth but also because of population aging and gains in insurance coverage. The dollar value of these services is projected to rise from $70.4 billion in 2013 to $83.1 billion in 2023. The report used 2013 as the base year for projections to capture the impact of the Patient Protection and Affordable Care Act (ACA). Changes to the ACA would affect those projections. For more information, go to https://www.aafp.org/news/government-medicine/20170612demandreport.html.

— AFP and AAFP NEWS staff

For more news, visit AAFP News at https://www.aafp.org/news.html.