Health insurance companies representing roughly 75% of patients in the U.S. signed an industry-led pledge this week aimed at improving patient care through streamlining the long-maligned prior-authorization process used by insurance companies to ensure patients are receiving appropriate care. (Getty Images; AP; iStock)
Prior-authorization is a process that requires providers to obtain approval from a patient's insurance provider before that provider can offer certain treatments or services. Essentially, the process seeks to ensure patients are getting the right solution for a particular problem.
However, according to Oz, the process has led to doctors being forced to spend enormous amounts of man-power to satisfy prior-authorization requirements from insurers. He noted during Monday's press conference that, on average, physicians have to spend 12 hours a week dealing with these requirements, which they see about 40 of per week.
"It frustrates doctors. It sometimes results in care that is significantly delayed. It erodes public trust in the healthcare system. It's something we can't tolerate," Oz insisted.
Prior-authorization is a long-criticized process that critics have argued blocks patients' access to care. (iStock)
Transparency is also a key part of the new commitments from insurance providers. Health plans enjoined with the commitments will pledge to provide clear and easy-to-understand explanations of prior-authorization determinations, including guidance for appeals. The commitment also states that by 2027, 80% of electronic prior-authorization approvals from companies will be answered in real-time.
Oz, during the Monday press conference, compared the industry-led pledge to the Bible, saying, "The meek shall inherit the earth."
"I always grew up thinking ‘meek’ meant weak, but that's not what meek means. ‘Meek’ means you have a sharp sword, a sword that could do real damage to people around you, but you decide, electively, to sheathe that sword and put it away for a while, so you can do goods, so you can do important things where once in a while we have to get together, even if we're competitors, and agree," Oz said Monday.
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"That's what these insurance companies and hospital systems have done," he continued. "They have agreed to sheathe their swords to be meek for a while, to come up with a better solution to a problem that plagues us all."
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