A new study published in Health Services Research examines racial disparities in prior authorization outcomes for cancer patients insured by a major national commercial provider. The research, conducted by Benjamin Ukert, Ph.D., from Texas A&M University School of Public Health, and a colleague at Penn State, analyzed data from 18,041 patients diagnosed with cancer between January 1, 2017, and April 1, 2020.
The study focused on the 13 most common cancers, excluding basal cell carcinomas, and examined prior authorization process outcomes. The sample was 85% white, 3% Asian, 10% Black, and 1% Hispanic, with 64% female and an average age of 53. The average prior authorization denial rate was 10%, with 5% denied due to medical necessity.
Contrary to expectations, the researchers found no significant racial or ethnic disparities in prior authorization outcomes for Black and Hispanic patients compared to white patients. Ukert stated, “In short, we found no racial or ethnic disparities in prior authorization outcomes for individuals identifying as Black and Hispanic, compared to white.” Interestingly, Asian patients had higher rates of prior authorization approvals compared to white patients.
The study’s findings provide valuable information on equity in the prior authorization process for specialty care. Ukert emphasized the importance of this research, saying, “Data on provider-insurer prior authorization is difficult to access and analyze, but this research could provide valuable information on equity in the prior authorization process in specialty care for patients, health care providers and plan managers, policy makers and employers.”
This study contributes to the ongoing discussion about healthcare disparities and the role of prior authorization in access to cancer care, offering insights for patients, healthcare providers, plan managers, policymakers, and employers.
