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February 16, 2012

Forum: Reform to shorten wait times

By Steven E. Newman and Kurt C. Anderson ----

We've all been there — sitting in the waiting room at the doctor's office, thumbing through the magazines and watching the clock as our patience dwindles, anticipating the moment the receptionist finally calls our name.

While the waiting game can almost feel personal at times, the fact of the matter is that Michigan physicians prefer to be in the exam rooms and operating suites working on their patients' behalf. And we prefer to see our staff right alongside us, delivering care directly to families.

Unfortunately, unnecessary red tape and bureaucracy often stand in the way. Redundant prior authorization forms for prescribing certain drugs create a significant administrative burden that delays patient care and limits the amount of time Michigan physicians and their staffs can spend directly with patients, addressing their health needs.

That is why Michigan physicians are supporting legislation by state Sens. Jim Marleau and Tonya Schuitmaker that asks the Michigan Health Insurance Commissioner to work with health insurance companies to develop one single, electronic prior authorization form to be used by all health insurance companies and pharmacy benefit managers across Michigan.

While most prior authorization forms request nearly identical information, more than 150 different insurance providers operating in Michigan each use their own unique forms, and not all of them can be submitted electronically.

Practically speaking, that means physicians and their staffs must sort through more than 1,000 pages of redundant forms and juggle numerous submission methods and requirements to perform the same task that could be otherwise handled with a single sheet of paper or click of the mouse. It is an antiquated and redundant system that delays the delivery of health care and stands in direct conflict with initiatives in Lansing and Washington, D.C., that are designed to move physicians towards e-prescribing and better, more efficient patient care.

The State of Michigan, federal programs, many health plans and other third-party payers have established strong initiatives for physicians to adopt electronic health record systems to enhance quality of care outcomes and efficiency. Current efforts require "meaningful use" of electronic health record systems and provide payment incentives for their use or penalties for failing to use electronic prescribing. Physicians are complying with these new requirements, but the prior authorization system has yet to catch up with the times.

By creating a single, universal prior authorization form we can change that, improve the patient's experience and streamline the process for prescribing the appropriate prescription drugs.

Senate Bills 429 and 430 empower physicians and their staffs to focus on improving their patients' health while cutting red tape and improving efficiencies in the delivery of health care. And it is a reform that will make better use of time for both physicians and their patients.

About the authors: Dr. Steven E. Newman is president of the Michigan State Medical Society; Dr. Kurt C. Anderson, DO, is president of the Michigan Osteopathic Association Board of Trustees.

About the forum: The forum is a periodic column of opinion written by Record-Eagle readers in their areas of interest or expertise. Submissions of 500 words or less may be made by e-mailing letters@record-eagle.com. Please include biographical information and a photo.

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