--- title: "Prior Authorization: A Hidden Influence on Provider Behavior" description: Dr. Stephen Salzbrenner at the University of Nebraska Medical Center, and his team recently published a study in the Journal of Medical Internet Research image: https://blog.jmir.org/hubfs/Stephen%20Salzbrenner%20blog%202.png --- [![JMIR Publications logo](https://blog.jmir.org/hs-fs/hubfs/JMIR-Publications_logo_2020_original.png?width=550&height=109&name=JMIR-Publications_logo_2020_original.png "JMIR Publications logo")](http://www.jmirpublications.com) Open main menu Close main menu [Research News](https://blog.jmir.org/tag/research-news) # Prior Authorization: A Hidden Influence on Provider Behavior ![Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/hs-fs/hubfs/Headshot.jpg?width=45&name=Headshot.jpg) [Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/author/reviewed-by-kayleigh-ann-clegg-phd) Published Date: 3 September 2025 10:19 a.m. [Share this blog post on Twitter](https://twitter.com/intent/tweet?text=I+found+this+interesting+blog+post&url=https://blog.jmir.org/prior-authorization-a-hidden-influence-on-provider-behavior) [Share this blog post on Facebook](http://www.facebook.com/share.php?u=https://blog.jmir.org/prior-authorization-a-hidden-influence-on-provider-behavior) [Share this blog post on LinkedIn](http://www.linkedin.com/shareArticle?mini=true&url=https://blog.jmir.org/prior-authorization-a-hidden-influence-on-provider-behavior) ![Dr. Stephen Salzbrenner, an Assistant Professor of Psychiatry at the University of Nebraska Medical Center, and his team recently published a study in the Journal of Medical Internet Research ](https://blog.jmir.org/hubfs/Stephen%20Salzbrenner%20blog%202.png) For many patients, getting a prescription for a new medication often involves an extra step for their doctor: **prior authorization (PA)**. This process, required by insurance companies, is intended to ensure safety and quality control. However, it can also create significant delays, contributing to provider frustration and, in some cases, negatively impacting patient care.   Dr. Stephen Salzbrenner, an Assistant Professor of Psychiatry at the [University of Nebraska Medical Center](https://www.unmc.edu/), and his team recently published a study in the [Journal of Medical Internet Research](https://www.jmir.org/) that delves into this very issue. Their paper, "[Prior Authorization of Medication and Its Influence on Provider Behavior: Latent Class Analysis](https://www.jmir.org/2025/1/e75361)," explores providers’ experiences with PA and investigates how PA affects clinical decision-making. Identifying Patterns in a Complex System The team’s study, a nationwide survey of over 1,100 prescribers used a sophisticated statistical method called latent class analysis. This allowed them to identify four distinct subgroups of providers based on their experiences with and behaviors related to prior authorization. These groups shared characteristics such as: - **Experience with PA denials**: Some providers had PA requests denied more frequently by insurance companies. - **Communication issues**: Some providers experienced more challenges communicating with insurance companies about PAs. - **Age, specialty, and patient load**: Providers’ age, speciality, and the number of patients on their caseload directly influenced their approach to prior authorization. The research also found that providers who reported the most "problematic" PA experiences were significantly more likely to make specific kinds of clinical decisions. These included changing a patient's diagnosis to meet PA criteria, avoiding newer medications altogether due to anticipated delays, and prescribing alternative medications when PA is delayed. The Human Cost of Paperwork The study’s findings reveal that negative experiences with PA can influence providers’ behaviors in potentially concerning ways. Some providers, particularly psychiatrists, younger clinicians, or those with a higher patient load, are more likely to alter their clinical decisions in response to PA-related challenges, such as delays, denials, or excessive paperwork.  This has important implications for insurance companies, as it highlights that a "one-size-fits-all" approach to PA may not be effective. Recognizing and addressing the distinct needs of different provider subgroups could help reduce the risk of clinical decisions that may negatively affect patient care or public health. For example, streamlining or tailoring the PA process for specific specialties or high-volume practices could help ensure patients receive the most appropriate and timely care. Dr. Salzbrenner and his team chose to publish their work in the *Journal of Medical Internet Research* due to its topical fit and high impact rating. The journal’s reputation as a leader in medical informatics and digital health makes it the ideal platform to share this critical research, which has implications for how insurance companies, providers, and patients interact within the healthcare system. Interested in a deeper look at how prior authorization affects provider behavior? [Watch the video](https://www.youtube.com/watch?v=ok1ARBU1Kyw) to hear directly from Dr. Stephen Salzbrenner, and [read the full research article](https://www.jmir.org/2025/1/e75361) to explore the detailed findings and their implications.     Subscribe Now ![Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/hs-fs/hubfs/Headshot.jpg?width=150&name=Headshot.jpg) #### Reviewed by Kayleigh-Ann Clegg, PhD [Follow me on my website](https://www.researchgate.net/profile/Kayleigh-Ann-Clegg) [Follow me on LinkedIn](https://www.linkedin.com/in/kayleighclegg/) Scientific News Editor @ JMIR Publications with a diverse background in clinical psychology, academic research, and digital health program development. I'm passionate about knowledge translation and accessibility, as well as data- and values-driven innovation. My goal is to make vital scientific knowledge clear and accessible to everyone so that we can better our lives and the world around us. ### Leave a Comment ## Related Articles [![Empowering Oncologists in Digital Health: Low-Burden Strategies for Patient Engagement](https://blog.jmir.org/hubfs/Monisola%20Jayeoba%20blog%20(1).png)](https://blog.jmir.org/oncologists-and-digital-health-a-win-win-for-patient-care) [Research News](https://blog.jmir.org/tag/research-news) ### [Oncologists and Digital Health: A Win-Win for Patient Care](https://blog.jmir.org/oncologists-and-digital-health-a-win-win-for-patient-care) Monisola Jayeoba, a PhD student in the Technology and Social Behavior Program at [Northwestern University](https://tsb.northwestern.edu/), recently published a significant paper in the [*Journal of...*](https://www.jmir.org/) [JMIR Publications](https://blog.jmir.org/author/jmir-publications-1) [Read More](https://blog.jmir.org/oncologists-and-digital-health-a-win-win-for-patient-care) [![Dr. Poncette, a professor of Clinical Implementation Science and Digital Health, an anesthesiologist, and a medical informatics specialist at Charité University Hospital in Berlin, recently co-authored a paper published in the Journal of Medical Internet Research](https://blog.jmir.org/hubfs/Akira-Sebastian%20Poncette-blog%20(1).png)](https://blog.jmir.org/cutting-through-the-noise-making-sense-of-hospital-alarms) [Research News](https://blog.jmir.org/tag/research-news) ### [Cutting Through the Noise: Making Sense of Hospital Alarms](https://blog.jmir.org/cutting-through-the-noise-making-sense-of-hospital-alarms) Imagine a hospital intensive care unit (ICU). 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But what if many of those alarms don't actually require... ![Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/hs-fs/hubfs/Headshot.jpg?width=45&name=Headshot.jpg) [Reviewed by Kayleigh-Ann Clegg, PhD](https://blog.jmir.org/author/reviewed-by-kayleigh-ann-clegg-phd) [Read More](https://blog.jmir.org/cutting-through-the-noise-making-sense-of-hospital-alarms) #### About - Menu Item One - Menu Item Two - Menu Item Three #### Services - Menu Item One - Menu Item Two - Menu Item Three #### News - Menu Item One - Menu Item Two - Menu Item Three Follow us on Facebook Follow us on LinkedIn Follow us on Twitter Follow us on Instagram ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Reviewed by Kayleigh-Ann Clegg, PhD", "url" : "https://blog.jmir.org/author/reviewed-by-kayleigh-ann-clegg-phd" }, "dateModified" : "2026-09-17T18:54:49.685Z", "datePublished" : "2025-09-03T14:19:41.000Z", "headline" : "Prior Authorization: A Hidden Influence on Provider Behavior", "image" : [ "https://blog.jmir.org/hubfs/Stephen%20Salzbrenner%20blog%202.png" ], "mainEntityOfPage" : { "@id" : "https://blog.jmir.org/prior-authorization-a-hidden-influence-on-provider-behavior", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://blog.jmir.org/hubfs/JMIR-Publications_logo_2020_original.png" }, "name" : "JMIR Publications" } } ```