Healthcare Payers

How Prior Authorization Impacts Patient Access to Care

October 20, 2023 - Prior authorization is a well-known headache for healthcare providers and clinicians, but for patients, it can mean something worse: poor patient access to care. A common utilization management strategy for payers, prior authorization has led to serious adverse health impacts on patients, a third of doctors said in a 2023 American Medical Association survey. For a quarter of...


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How Healthcare Payers Measure Patient Experience, Use CAHPS Surveys

by Sara Heath

Just as hospitals and clinics place high priority on understanding the patient experience of care, as do healthcare payers looking to offer high-quality and satisfactory plans to beneficiaries. While...

Drug Formulary Exclusion Lists Reduce Patient Access to Treatment

by Sara Heath

Drug formulary exclusion lists are getting longer, making it more difficult for patients to access the medications and treatments they may need to manage their illnesses, according to a recent study...