News: AHA survey shows commercial health insurers apply policies that delay patient care and increase costs

Some commercial health insurers apply policies that delay patient care, burden providers, and increase costs, according to a new report and infographic from the American Hospital Association (AHA). The report found that 78% of hospitals and health systems reported that their experience with commercial insurers has gotten worse, and only 1% reported it is getting better. The report focused on patient and hospital experiences with prior authorization and payment delays, denials, and appeals, reported AHA News in a related article.

The report used surveys from 2019, 2021, and most recently February 2022, with more than 900 hospitals responding total. It shows the challenges from before the COVID-19 public health emergency have persisted since, with hospitals and health systems reporting delays and denials for medically necessary care have consistently grown. Appeals are reported to result in insurers overturning their earlier decisions most of the time too, calling into question the burden of challenging the initial denials with 95% of hospitals and health systems seeing an increase in time spent on seeking prior authorization approvals.

“These survey results are stark evidence that some commercial health insurers deny care while hospitals and health systems focus on providing care,” said AHA President and CEO Rick Pollack. “Patients deserve comprehensive health coverage with the protections they were promised when they signed up.”

The report offered solutions for policymakers to reduce risk and burden associated with some commercials health insurer practices, such as streamling prior authorization processes and increasing oversight on insurers to target specific inappropriate behavior.

Editor’s note: To read AHA’s coverage of this topic, click here. To access the full AHA report, click here.