Publish Year: 2023

A year after the federal government launched the IDR process under the No Surprises Act, over 330,000 balance billing disputes have been filed

97% of practices reported that their patients experience delays or denials for medically necessary care due to prior authorization requirements

35% of medical groups said they spend upwards of 35 minutes on an average prior authorization request. Nearly 5% reported spending 91 minutes or more on a single request

Almost 6 in 10 practices saw 15%+ of their patients either switch from traditional Medicare to Medicare Advantage or between Medicare Advantage plans

95% of practices provide care to patients covered by Medicare Advantage, and 75% report they are seeing an increasing number of these patients

Research suggests that 81% of the time treatments that are comparatively effective are also cost-effective

Even before 2020, the public health workforce had shrunk by more than 15%; COVID-19 caused even more attrition

50% of a psychologist’s salary is covered through fee-for-service revenue because psych CPT codes do not reimburse at the same level as medical

Approximately 20% of PT patients drop out of treatment within the first three visits, while 70% of patients do not complete their full course of care

RTM codes are vastly underutilized with only 0.1% code usage