Tamara Thomas

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More than one million people in the U.S. receive radiation therapy each year to treat cancer and other diseases, according to the American Society for Radiation Oncology (ASTRO). In December 2024, ASTRO surveyed over 750 radiation oncologists nationwide about how insurance practices, known as prior authorization, affect their patients and clinics. The results reveal troubling trends, including treatment delays, adverse outcomes, and increased staff burnout.
Nearly all the responding physicians (92%) reported that prior authorization causes treatment delays for their patients, which can last five days or longer. One-third said these delays led to patients abandoning radiation therapy, and nearly as many (30%) noted serious adverse events such as emergency room visits, hospitalization, or permanent disability. Alarmingly, 7% said prior authorization had contributed to a patient’s death. Most doctors (82%) indicated they had to modify their prescribed treatment plans to less optimal options, and more than half (58%) said they were unable to adhere to established guidelines at some point.
This administrative burden has also intensified over time. More than two-thirds of doctors observed that the process has grown worse in the past three years. Clinic operations are strained as well, with 64% of respondents noting they were forced to hire additional staff to manage the authorization process. Fifty-four percent reported that more than half of their cases now require prior authorization, a marked increase from previous surveys.
Ironically, appeals lead to the approval of three-fourths of denied requests, raising doubts about the effectiveness of prior authorization in upholding evidence-based standards. Many radiation oncologists also struggle to secure approvals for supportive medications, including anti-nausea drugs and pain therapies. Overall, ASTRO’s data illustrate the ways in which prior authorization can harm cancer patients’ outcomes and exacerbate burnout in care teams, underscoring a growing need for policy reforms to protect patient safety and improve the delivery of cancer treatment.
Source: <a href="https://www.astro.org/getmedia/8d6c0ff0-cd7e-4f94-b77e-a8ef81b234e0/PriorAuthSurvey_2024ExecutiveSummary.pdf">ASTRO</a>

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responding physicians (92%) reported that prior authorization causes treatment delays for their patients

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