AHIP Survey: Prior Authorization Grounded in Clinical Evidence and Selectively Used

Just like doctors use scientific evidence to determine the safest, most effective treatments, health plans rely on data and evidence to understand what treatments best improve patient health and target prior authorization programs to promote appropriate care. The vast majority of health plans’ prior authorization programs incorporate physician input and design their prior authorization programs with the goals of improving quality and protecting patient safety. That’s according to a recent commercial survey of health plans on prior authorization from America’s Health Insurance Providers (AHIP).

The report found that health plans use multiple sources of evidence-based studies, guidelines and federal standards