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Texas Voters React to Issue of Medical Prior Authorization

RICHARDSON, Texas – Blue Cross and Blue Shield of Texas (BCBSTX) is committed to providing access to quality, cost-effective healthcare. As part of this commitment, BCBSTX recently funded a poll of Texas voters to better understand their perspectives on the issue of prior authorization.

The poll by Baselice & Associates was conducted in November 2018. The largest concentrations of voter interviews were in the Dallas-Fort Worth and Houston metro areas, 30% and 25%, respectively. Overall, 61% of interviews were conducted in urban areas, and 39% were in rural areas. In addition, 56% of voters interviewed were self-identified as Anglo, 20% were self-identified as Hispanic and 13% were self-identified as African American. A total of 33% of voters interviewed were between ages 18-44, while 27% were 65 or older.

Texas Voters On Prior Authorization:

Voters were asked about the practice of allowing insurance carriers to cover only those medical tests, procedures and operations that are pre-approved by the insurance company. In addition, they were asked whether insurance companies should be allowed to not cover services when clinical criteria and the generally accepted standard of care indicates a doctor or hospital is suggesting an unnecessary medical test, procedure or operation. Texas voters' interview responses to those questions included the following: 

  • 97% agree that "patients deserve to know BEFORE a medical procedure or test what they will personally pay and if it will be covered by insurance."
  • 70% agree that "it is appropriate for insurance carriers to lower premium costs by establishing programs that ensure payment is made only for medically approved services."  
  • 64% agree that "the physician should have responsibility for managing and directing the patients' care, but the insurance carrier should have responsibility for checking to see if the medical tests and procedures are covered and really necessary." 

In addition, Texas voters were asked about a proposal to permit insurance carriers to cover only those medical tests, procedures and operations that are pre-approved by the insurance company as necessary and effective. A strong majority of Texas voters polled agreed with the following statements:

  • 75% overall favored: "When a medical test or procedure is not necessary, the patient can be harmed or become more sick. This proposal will help protect patients."
  • 77% overall favored: "When a medical test or procedure is not necessary, patients get charged for services that do not help cure them. This proposal will help reduce unnecessary procedures and costs for patients."
  • 71% overall favored: "This proposal will impose financial penalties on doctors and hospitals who request unnecessary tests and procedures."
  • 71% favored: "Texas taxpayers help fund health care and this can help control health care costs, and this will free up state revenues for public education and other services."
  • 76% favored: "The average person's insurance premium is hundreds and even thousands of dollars higher per year due to costs associated with unnecessary test and procedures. This proposal can help keep insurance premiums in check/from increasing so fast."

Conclusions: 

  • BCBSTX believes that just like physicians, insurers don't like red tape either;
  • BCBSTX believes that just like physicians, insurers would like to streamline the health care process to make it easier for patients to obtain the right care, at the right time and in the right place; and
  • BCBSTX believes that just like physicians, insurers would like to improve coverage and access for all Texans by making insurance products more affordable.

 

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About Blue Cross and Blue Shield of Texas 
Blue Cross and Blue Shield of Texas (BCBSTX) — the only statewide, customer-owned health insurer in Texas — is the largest provider of health benefits in the state, working with nearly 80,000 physicians and health care practitioners, and 500 hospitals to serve 5 million members in all 254 counties. BCBSTX is a Division of Health Care Service Corporation (which operates Blue Cross and Blue Shield plans in Texas, Illinois, Montana, Oklahoma and New Mexico), the country's largest customer-owned health insurer and fourth-largest health insurer overall. Health Care Service Corporation is a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association.



A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

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