Washington, D.C. – (December 14, 2023) – A new AHIP resource highlights how the targeted use of evidence-based prior authorization can help ensure patients get care that’s not only safe and effective, but also affordable.
Doctors and clinicians provide important care and life-saving treatment. That’s why health insurance providers are committed to working with health care providers and patients to avoid care that is inappropriate, unnecessary, and more costly.
Takeaways include:
- One study found that 60% of lower back MRIs were inappropriate; MRIs can cost $2,500 more than recommended alternatives like physical therapy.
- Evidence-based guidelines suggest ultrasounds should be the first line of testing in diagnosing certain areas of abdominal pain before ordering other types of imaging. The national average cost of an ultrasound is $400, compared to $900 for a CT scan.
- Generic medications are on average 80-85% less expensive than brand name medications. Prior authorization can promote the prescribing of generic equivalents, and help protect patients from significantly higher costs.
Health care providers remain committed to helping patients get safe, evidence-based, clinically appropriate, and affordable care.
Click here for more information on prior authorization.