2023
DOI: 10.1016/j.gore.2023.101159
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Insurance and racial disparities in prior authorization in gynecologic oncology

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Cited by 4 publications
(7 citation statements)
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“…Patients with germline HRD mutations, such as BRCA or BRIP1, are diagnosed with ovarian cancer at younger ages when patients are more likely to have employer-based private insurance. While we did not see a difference by insurance in this study, we previously found high rates of prior authorization in certain private insurance plans ( Smith et al, 2023 ). The higher rate of prior authorization could reflect genetic-agnostic prior authorization policies that may flag patients receiving more care (e.g., BRCA mutation positive patients may use more health care, given other cancer risks and recommended screening).…”
Section: Discussioncontrasting
confidence: 84%
See 2 more Smart Citations
“…Patients with germline HRD mutations, such as BRCA or BRIP1, are diagnosed with ovarian cancer at younger ages when patients are more likely to have employer-based private insurance. While we did not see a difference by insurance in this study, we previously found high rates of prior authorization in certain private insurance plans ( Smith et al, 2023 ). The higher rate of prior authorization could reflect genetic-agnostic prior authorization policies that may flag patients receiving more care (e.g., BRCA mutation positive patients may use more health care, given other cancer risks and recommended screening).…”
Section: Discussioncontrasting
confidence: 84%
“…We developed our search terms from a registry of patients experiencing prior authorization that had been developed for quality improvement and maintained in one clinic (Supplemental Table 2 ). Using previously published methodology, we validated the search terms through chart reviews using examples of these identified patients who experienced prior authorization ( Smith et al, 2022 , Smith et al, 2023 ).…”
Section: Methodsmentioning
confidence: 99%
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“…Prior studies have suggested that additional burdens are associated with delayed or forgone care and are more likely to affect those who are already at risk for compromised or fractured care, including Black or African American, disabled, female, and low-income patients . Research also shows that PA may place disproportionate limitations to access on vulnerable populations, patients of Asian descent, and those with Medicare Advantage plans . Dealing with PA issues adds an extra layer of stress, which is known to increase anxiety and can worsen treatment-related and disease-related symptoms and adverse effects …”
Section: Discussionmentioning
confidence: 99%
“…1,2 Patients' physicians are permitted to appeal coverage denials through avenues the insurer stipulates, and which usually involve telephone conversations with insurer designees ("peer-to-peer" discussions) and formal appeal letters. Insurers assert that this practice adjudicates the best use of medical resources and protect patients from unnecessary medical interventions, but physicians across a spectrum of medical specialties argue that these practices delay patient care, 3,4 discriminate, 5,6 deter enrollment to and confound interpretation of clinical trials, 7,8 and burden physicians [9][10][11][12] with unnecessary clerical work and costs. 13 Cancer patients -whose lives might depend on multidisciplinary systemic, surgical, and radiotherapeutic treatments -are too familiar with insurer delays and denials.…”
Section: Introductionmentioning
confidence: 99%