Patient-centered care is a major
goal across the healthcare industry. By empowering patients to play an
active role in their care and assume a pivotal function in developing
their treatment plan, this care model can increase patients’
satisfaction with services and ultimately improve treatment quality and
Despite these clear advantages
of adopting patient-centered care, healthcare providers and patients
often face significant obstacles in putting this concept into practice.
Utilization management programs, such as prior authorization, create
barriers for patients by delaying the start or continuation of necessary
treatment and negatively affecting patient health outcomes. The manual,
time-consuming processes used in these programs burden providers and
divert resources away from direct patient care. However, health plans
and benefit managers contend that utilization management programs are
employed to control costs and ensure appropriate treatment.
Last week the House of
Representatives Committee on Ways & Means passed H.R. 8487, the
Improving Seniors’ Timely Access to Care Act, out of Committee by a
unanimous vote. This legislation amends the Social Security Act to
establish requirements concerning the use of prior authorization under
Medicare Advantage plans. This was the next critical step to getting a
vote before the full House of Representatives. On the Senate side,
efforts to reform the prior authorization process got a major shot in
the arm when Senator Marco Rubio (R-FL) announced his support for S.
3018, Improving Seniors' Timely Access to Care Act.
to advocate for our members and the healthcare industry, Senator Rubio’s
support for S. 3018 provides AAHAM further impetus in our efforts to
get this legislation passed” stated AAHAM President, Lori Sickelbaugh, CRCE. “AAHAM
understands the importance of making sure our voices are heard in
Washington, and we are excited to keep building on our successes and
grassroots efforts” added Sickelbaugh.
Senator Rubio is a respected
member of the United States Senate and a leading Republican voice for
healthcare reform. His support for S. 3018 gives AAHAM continued
momentum in its efforts to get this legislation to the President’s desk
before the end of the year.
“The key to continuing this type of headway is to cultivate this awareness of these bigger issues at the state levels,”
said AAHAM Second Vice President, Erin Miskelly, CRCE, CCT. “There
truly is strength in numbers” stated Miskelly. AAHAM Government
Relations Chair, Karin Murchison, CRCE, shared, “This
is exciting news for our industry and a huge accomplishment of AAHAM
and our members, proving that our hard work and efforts do pay off!"