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Survey: 30 Percent of Radiation Oncologists Say Prior Authorization Delays Lead to Adverse Events for Cancer Patients

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Sixty-eight percent of radiation oncologists said average delays with prior authorization are five days or more, and seven percent of survey respondents said these delays have been a contributing factor in the death of cancer patients.

Prior authorization delays have become more widespread in radiation oncology and have contributed to abandonment of radiation therapy, adverse effects, and death in significant numbers of cancer patients, according to results from a new survey of radiation oncologists by the American Society of Radiation Oncology (ASTRO).

Conducted in the fall of 2024, the ASTRO survey of over 750 radiation oncologists found that 92 percent reported delays in treatment due to challenges with prior authorization. Thirty-three percent of the survey respondents said these delays have led patients abandoning radiation treatment and 30 percent noted adverse events, ranging from emergency room visits to permanent disability.

According to the ASTRO survey, 7 percent of radiation oncologists indicated that prior authorization delays contributed to a patient’s death.

Survey: 30 Percent of Radiation Oncologists Say Prior Authorization Delays Lead to Adverse Events for Cancer Patients

A recent ASTRO survey of over 750 radiation oncologists found that 92 percent reported delays in treatment for cancer patients due to challenges with prior authorization.

“These survey findings confirm what radiation oncologists witness daily: prior authorization policies are failing people with cancer, causing avoidable delays that are dangerous and, in too many cases, deadly,” emphasized Howard M. Sandler, M.D., FASTRO, Chair of the ASTRO Board of Directors.

Sixty percent of the survey respondents said prior authorization challenges have “increased greatly” in the last three years and 68 percent of radiation oncologists noted the average prior authorization delay is five days or longer, an increase of 16 percent from a similar ASTRO survey conducted in 2020.

In addition to adverse effects in patient care, survey respondents noted the impact of prior authorization delays on staff. Challenges with prior authorization led to reallocated staff time, according to 80 percent of respondents. Fifty-seven percent said navigating prior authorization significantly worsens staff burnout.

Forty-nine percent of respondents cited insufficient transparency from insurers on the prior authorization review process. Emphasizing the need for a “real-time process for coverage decisions,” Dr. Sandler is hopeful that the current ASTRO-supported bill “Improving Seniors’ Timely Access to Care Act of 2024” (S.4532, H.R.8702) will have an impact in addressing the issues with prior authorization delays.

“We encourage Congress to act now to help end these life-threatening delays and put Medicare Advantage on a path toward transparency and accountability by passing this legislation before the current session ends,” implored Dr. Sandler.

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