There is increased focus on the benefits and burdens associated with prior authorization. NCQA believes that care should be based on the best available evidence and that accountability should be shared for timely delivery of care. Prior authorization should support the right care, at the right time, at the appropriate cost, and should be transparent to clinicians and patients.
NCQA recognizes that prior authorization should be near real-time through the interoperable exchange of clinical data and prior authorization requests. With consideration of the pressing need to align and automate prior authorization policies, NCQA is convening a roundtable discussion as a forum for exchanging ideas for reducing burden and cost.
The goal of our initial round table, scheduled for April 30, is to bring key industry leaders together for discussion and exploration of issues associated with prior authorization. The intended outcome is to begin enhancing partnerships for streamlining and standardizing processes for burden reduction.
NCQA will share the results of the roundtable and next steps—look for details here on the blog.
Matt Brock is the Director of Communications at NCQA. After more than two decades working in broadcast journalism, Matt now leads NCQA’s efforts to develop unique content that engages and informs consumers as well as providers, plans and policymakers via this blog, our website, NCQA.org and numerous social media platforms. Matt’s goal is to educate consumers and to direct them to the best resources when considering quality in their health care decisions.