I’ve always disliked prior authorization, the process by which a managed care plan requires a physician to get permission before writing a prescription for a drug, even when it’s on formulary. So when I got a call from a Managed Healthcare Executive reporter asking about “innovations in prior authorization,” I talked about ways to eliminate the need for prior authorization in the first place.
The article (Prior authorization process lightened by electronic information) does a good job laying out the rationale for prior auth in an age of expensive meds and cost pressures. But I was also happy to see the last column devoted to my suggestions of alternatives:
- Real-time decision support tools (like Safe-Med) that include clinical and business rules
- Comprehensive evidence based clinical information resources (like UpToDate)
- e-prescribing, to make the prior auth process less painful and more automated when it needs to occur