20% of U.S. Adults Report Denial of Doctor-Recommended Care
A new Commonwealth Fund study found that one in five U.S. adults were denied doctor-recommended care, leading to deteriorating health outcomes and financial strain. The research highlights increasing patient frustration with claims review processes and prior authorization barriers. Insurers maintain their utilization management protocols are medically appropriate. The findings come as regulatory scrutiny of managed care denial practices intensifies at both federal and state levels.
Rising denial rates increase the likelihood of state and federal regulatory action targeting MCO utilization management practices, including prior authorization reform, appeals transparency requirements, and potential network adequacy enforcement.
Managed Care
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