AJMC February 25, 2025
Key Takeaways
- Insurance claim denials have risen 16% from 2018 to 2024, affecting access to essential medications like insulin and albuterol.
- Denials often result from formulary exclusions, step therapy, and medical necessity requirements, contradicting clinical best practices.
- Administrative burdens from insurance processes detract from direct patient care, causing delays and frustration for providers and patients.
- Policy changes and advocacy are needed to streamline insurance processes and improve patient access to necessary treatments.
Delays in receiving coverage for essential medications like insulin and albuterol can worsen symptoms, increase costs, and add stress for patients.
When health insurance denies coverage for essential medications, the consequences can be severe. From formulary exclusions to step therapy hurdles, patients face barriers that often...
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