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Related Concept Videos

Preventive Healthcare Services01:30

Preventive Healthcare Services

Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
Introduction To Health Care Delivery System01:18

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 System01:29

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...
One-Compartment Open Model for Extravascular Administration: Zero-Order Absorption Model01:12

One-Compartment Open Model for Extravascular Administration: Zero-Order Absorption Model

Extravascular administration, such as oral or intramuscular routes, is a non-invasive drug delivery method, often preferred for ease and patient compliance. A key factor here is absorption, which dictates how quickly and effectively the drug enters the bloodstream from the administration site. Absorption follows either zero-order or first-order kinetics.
Zero-order absorption maintains a steady rate irrespective of the amount of drug left to be absorbed, making it a constant process. In the...
Patient-centered Care01:13

Patient-centered Care

Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
Traditional Level Of Health Care System01:26

Traditional Level Of Health Care System

The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...

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Related Experiment Videos

Prior Authorization: Moving Toward Zero.

Ceci Connolly1, Charles Bloom2

  • 1President and Chief Executive Officer, Alliance of Community Health Plans, Washington, DC, USA.

NEJM Catalyst Innovations in Care Delivery
|July 7, 2026
PubMed
Summary
This summary is machine-generated.

Prior authorization, a process for approving medical care, causes administrative burdens and delays. While it can improve safety and reduce costs, its use should be significantly limited in healthcare.

Related Experiment Videos

Area of Science:

  • Health Services Research
  • Healthcare Administration

Background:

  • Prior authorization is debated as a driver of administrative burden and delayed care versus a tool for safety and cost reduction.
  • Significant national variations exist in prior authorization implementation despite established clinical criteria.

Purpose of the Study:

  • To examine the role and impact of prior authorization in healthcare.
  • To advocate for a reduced and limited application of prior authorization processes.

Main Methods:

  • Analysis of prior authorization practices within three provider-aligned health plans.
  • Case study approach detailing real-world examples.

Main Results:

  • Prior authorization presents a complex duality, impacting administrative workload, patient access to care, and healthcare costs.
  • Variations in application highlight inconsistencies in utilization management.

Conclusions:

  • Prior authorization has a justifiable role in healthcare.
  • The study advocates for a significant reduction in prior authorization use, moving towards minimal implementation.