Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

Barriers to Effective Communication II

Barriers to Effective Communication II

The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...

Introduction To Health Care Delivery System

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...

Issues And Trends In Healthcare Delivery System

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...

Methods of Documentation VI: Case Management Model

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...

Prescription, Nonprescription and Orphan Drugs

Prescription, Nonprescription and Orphan Drugs

Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...

Methods of Documentation II: POMR

Methods of Documentation II: POMR

The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Income-related disparities in the value of health care in South Korea.

Health affairs scholar·2025

Same author

Effect of Systolic Blood Pressure Measurement Error on the Cost-Effectiveness of Intensive Blood Pressure Targets.

Annals of internal medicine·2025

Same author

Integrated health systems and medical care quality during the COVID-19 pandemic.

Health services research·2025

Same author

Potential US Health Care Savings Based on Clinician Views of Feasible Site-of-Care Shifts.

JAMA network open·2024

Same author

Active steps to reduce administrative spending associated with financial transactions in US health care.

Health affairs scholar·2024

Same author

Artificial Intelligence in U.S. Health Care Delivery. Reply.

The New England journal of medicine·2023

Search research articles

Related Experiment Video

Updated: Jun 12, 2025

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery

Published on: April 14, 2016

Perceptions of prior authorization burden and solutions.

Nikhil R Sahni^1,2, Brooke Istvan³, Celia Stafford⁴

¹Department of Economics, Harvard University, Cambridge, MA, 02138, United States.

Health Affairs Scholar

|September 27, 2024

Summary

The prior authorization (PA) process burdens patients, providers, and payers. While payers plan AI integration, providers show low adoption due to budget and trust issues, hindering PA process improvements.

Keywords:

access to care cost of healthcare nurses patients physicians private health insurance

More Related Videos

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

Published on: January 18, 2018

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

Related Experiment Videos

Last Updated: Jun 12, 2025

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery

Published on: April 14, 2016

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

Published on: January 18, 2018

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

Area of Science:

Health Services Research
Healthcare Administration
Health Informatics

Background:

The prior authorization (PA) process imposes significant time and financial costs on patients, healthcare providers, and insurance payers.
Despite potential savings, specific actionable strategies for each stakeholder group within the PA process remain underexplored, leading to missed opportunities for optimization.

Purpose of the Study:

To investigate the perceived burden of the prior authorization (PA) process across patients, providers, and payers.
To assess stakeholder receptivity to potential changes, including the adoption of artificial intelligence (AI), within the PA workflow.

Main Methods:

A survey was conducted among 1005 patients, 1010 provider employees, and 115 private payer employees.
Data collected focused on perceived wait times, approval rates, burden, and attitudes towards AI in the PA process.

Main Results:

Patients experienced the longest wait times but reported the lowest perceived burden and highest approval rates, largely due to indirect engagement.
Provider respondents indicated that prior authorization consumes time equivalent to over 100,000 registered nurses annually.
A significant majority of private payers (65%) plan to integrate AI into PA within 3-5 years, contrasting sharply with provider adoption intentions (11%).

Conclusions:

Payers are more inclined towards AI adoption for prior authorization (PA) than providers, citing cybersecurity and infrastructure as barriers.
Providers face budget constraints and trust issues, limiting their AI adoption for PA.
Addressing these disparate perspectives and barriers is crucial for realizing potential efficiencies and cost savings in the prior authorization process.