The Realities of Delayed Care: Stories From the Front Lines

Delayed care is one of the most dangerous threats in healthcare in America. When treatment gets delayed, for whatever reason, you are facing further progression of the issue and complications later down the line. To put it lightly, outcomes worsen. 

According to national surveys, 93% of physicians say prior authorization delays care, and 24% say these delays have led to a patient’s hospitalization.

Optometry: Vision Lost Because of Delays 

A woman in California was experiencing problems with her vision. She was made to wait for months before the authorization came through for her to see a neuro‑ophthalmologist. She got the approval, yes, but by that time, her optic nerve had suffered irreversible damage. She is now legally blind. 

Cardiology: Delays With Deadly Consequences 

PCSK9 inhibitors, which are used to reduce cardiovascular risk, have an 80% denial rate for initial applications. 80%. While many patients eventually receive approval, they remain at risk for weeks on end for heart attacks and strokes. 

Mental Health: Delays That Push Patients Into Crisis 

We know more about mental health than we ever have before. However, mental healthcare faces some of the worst delays in America. Insurers are frequently denying or delaying treatment, whether it be medication or therapy. This leads to crisis in many patients' lives.  

Why?

Because insurers are using:

• prior authorization

• step therapy

• paperwork and

• algorithms

These “tools” are designed purely to slow down care and reduce costs. But that is the issue. Insurers are focused on reducing costs, not on providing care.