Improving Time to Biologic Therapy Through Structured Prior Authorization Support
This example shows what a completed quality improvement (QI) project using GreenlightPA might look like. Data shown below is fictional and for demonstration only.
Aim Statement
We aimed to increase the percentage of patients with moderate to severe atopic dermatitis receiving dupilumab within 30 days of prior authorization submission from a baseline of 45% to 70% over 3 months by using structured PA documentation through GreenlightPA.
Methods
- Setting: Academic dermatology clinic
- Population: Patients requiring biologic therapy for atopic dermatitis
- Intervention: Use of GreenlightPA structured PA checklist and documentation tool
- Comparison: Standard PA process prior to implementation
- Data Source: QI tracking spreadsheet (no PHI collected)
Results
Approval Rate
62% → 81%
% Receiving Medication ≤30 Days
45% → 74%
Median Days: Submission → Received
28 → 16
Use of structured documentation was associated with improved approval rates and faster time to therapy initiation.
Discussion
This project suggests that standardized PA documentation may reduce insurer delays and improve patient access to therapy. Limitations include non-randomized design and small sample size, consistent with typical clinic-based QI projects.
Conclusion
A structured PA support tool was associated with improved documentation, higher approval rates, and shorter time to medication access. This QI framework can be replicated in other clinics and specialties.