Shocking Study Exposes Dark Side of Cancer Care: Over 20% Denied Vital Treatment! The Real Cost of Prior Authorization Revealed by Patients!

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In a groundbreaking study shedding light on the often-overlooked impact of prior authorization on cancer treatment, over 20% of individuals with cancer faced denials or delays in clinician-recommended care. The study, driven by patient experiences, emphasizes the significant consequences of prior authorization requirements.

Bridgette Thom, PhD, a senior research specialist at Memorial Sloan Kettering Cancer Center, shared that the motivation behind the study was to include the patient voice in a conversation dominated by provider perceptions and productivity concerns.

Surveying 178 people with cancer, the study revealed distressing results. A staggering 22% of respondents did not receive recommended care due to denials or delays, contributing to heightened patient anxiety and administrative burdens. More than two-thirds experienced delays in care, with a significant portion enduring delays lasting 2 weeks or longer.

Participants described the prior authorization process as overwhelmingly negative, with 40% characterizing it as bad and 32% as horrible. Thom highlighted the importance of centering the study around patient perspectives, allowing a deeper understanding of the anxiety and fear caused by delays in diagnosis and treatment.

When asked about the study’s implications, Thom stressed the basic level of harm experienced by patients, not only in delayed care and medications but also in the additional time and effort spent navigating the complex prior authorization process. The potential danger lies in delayed cancer care, affecting crucial aspects such as diagnosis, necessary imaging, and symptom management.

Thom acknowledged the ideal scenario of eliminating prior authorization in acute illness situations. However, she suggested immediate actions, including raising awareness about the issue and conducting more patient-centered research to quantify the downstream consequences of prior authorization. Policy efforts to enhance transparency and timely decisions in the prior authorization process are also deemed necessary.

This study serves as a crucial step in amplifying the patient perspective, revealing the real-life impacts of insurance companies’ strategies on both physical and psychosocial aspects of cancer patients’ lives.

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