Good News - Dreaded Medical Paperwork Reduced

Some good news for patients and doctors - the paperwork required by health insurers to get many medical procedures and tests is getting rolled back. Access the full Wall Street Journal article through this link.

UnitedHealthcare, the largest health insurer in the U.S., has stated it would cut its use of the prior authorization process. Other major insurers, such as Aetna and Cigna, are moving in the same direction. These steps are a sign that the health insurance industry is rethinking prior authorization, which has long been a source of frustration for doctors and patients.

UnitedHealthcare (UHC) states that the change is the result of listening to complaints, and taking a hard look at themselves. While UHC should be credited for the change, it has not happened without some outside pressure. Medicare Advantage enrollment has been surging in recent years, and UHC is the largest carrier in this important market. While the large majority of Medicare Advantage members report positive satisfaction with their plans, there have been complaints about prior authorization. Meanwhile, the Federal government has been challenging the Medicare Advantage carriers on reimbursement levels, so it seems to me that the carriers doing everything they can to position themselves in a positive light.

What does all this mean? It's definitely a win for us seniors. In the vast majority of cases, prior authorizations are approved, which is just a waste of time for your doctor and frustrating to the patient. These changes will make it easier for our doctors to get us the care we need.

In regard to negotiations between the Federal government and the Medicare Advantage insurers, I expect it will play out with some adjustments that are acceptable to all parties. As I stated earlier, the large majority of enrollees really like their plans, and seniors want choices, so Medicare Advantage enrollment will likely continue to grow. Stay tuned for more news on these negotiations.

If you have questions or concerns about how these issues affect your coverage, don't hesitate to call me at 978-447-3737.

Yours in good health,

Jeff

Jeffrey W. Werner
OTL Benefits – “On The Level”