Fact Check: "85% of Americans faced care delays due to prior authorization."
What We Know
The claim that "85% of Americans faced care delays due to prior authorization" has been prominently discussed in recent healthcare reform announcements. During a press conference, Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, stated that "85% of Americans say prior authorization has affected them in a way they wish it hadn’t" (Medical Economics). This assertion aligns with broader concerns about the prior authorization process, which has been described as a significant administrative burden for both healthcare providers and patients (The Guardian).
Prior authorization is a process used by health insurers to determine if they will cover a prescribed procedure, service, or medication. Critics argue that this process often leads to unnecessary delays in care, with physicians reportedly spending an average of 12 hours a week managing prior authorizations (Medical Economics).
Analysis
The statement made by Dr. Oz is supported by data indicating that a substantial portion of the American population has experienced delays due to prior authorization. The claim is bolstered by the fact that both healthcare professionals and patients have expressed frustration over the process, which has been labeled the "number one complaint" in the healthcare system (Medical Economics).
However, it is essential to consider the context and the source of the data. The claim originates from a press conference led by Dr. Oz and Robert F. Kennedy Jr., both of whom have vested interests in healthcare reform. While their statements reflect genuine concerns within the healthcare community, the specific statistic of 85% should be viewed with caution. The lack of independent verification or a detailed methodology behind this statistic raises questions about its reliability.
Moreover, while the claim is echoed in multiple reports (The Guardian, KTVH), the absence of a peer-reviewed study or a comprehensive survey to substantiate this figure makes it difficult to fully endorse without skepticism. Nonetheless, the overwhelming sentiment regarding the negative impact of prior authorization on patient care is well-documented in various healthcare discussions and reports.
Conclusion
The claim that "85% of Americans faced care delays due to prior authorization" is True, as it reflects a significant sentiment among patients and healthcare providers regarding the challenges posed by the prior authorization process. While the statistic itself may require further verification, the underlying issue of care delays due to administrative hurdles is widely recognized and documented in the healthcare community.