When people think about barriers to healthcare, they usually mention cost, transportation, insurance, or whether a provider is close by. But there is another barrier that is harder to notice.
At first, paperwork, prior authorizations, insurance approvals, filling out the same forms again, missing records, phone calls between offices, requests for more documents, appeals, confusing instructions, and different steps for each health plan may seem manageable. But when you add them all up, they create an administrative maze of paperwork that separates patients and the care they need.
For someone who is already sick, overwhelmed, working several jobs, caring for family, or struggling to understand the healthcare system, this maze becomes a real barrier to care.
When ‘Just One More Step’ Becomes a Barrier
Picture your doctor telling you that you need a test, a procedure, medicine, or to see a specialist. You are ready to take the next step, and so is your provider.
But first, your health plan asks for more information. Then the approval gets delayed.
Next, they ask for another document. After that, you wait for someone to return your call.
Days can turn into weeks, and some patients eventually give up. This really happens.
A survey found that 94% of physicians reported prior authorization delays access to necessary care. In comparison, 78% said that patients sometimes or often abandon a recommended treatment due to authorization issues.
At that point, paperwork is no longer just an inconvenience. It becomes a real barrier to getting care.
Patients Aren’t the Only Ones Doing the Paperwork
Much of this paperwork happens behind the scenes in medical offices. Doctors and their staff spend a lot of time submitting requests, checking on approvals, sending additional documents, appealing denials, communicating with health plans, and keeping patients updated.
In a 2024 survey, doctors reported completing an average of 43 prior authorizations each week. Those requirements consumed approximately 12 hours of physician and staff time per physician every week.
Every hour spent on complicated paperwork is time not spent answering patient questions, coordinating care, following up after visits, or helping someone understand their next steps. Paperwork does more than create extra work.
It takes away time and resources from healthcare.
Delayed Care Becomes More Complicated Care
Health problems don’t wait for paperwork. If a test is delayed, the diagnosis is delayed too.
If treatment is delayed, symptoms worsen. If a procedure is postponed, someone may live with pain or less mobility longer than they should.
There is also a ripple effect. When patients cannot get the next step in care, they might return to their doctor, visit urgent care, undergo additional tests, or seek other services while they wait.
Nearly 90% of physicians surveyed reported that prior authorization leads to greater overall use of healthcare resources. In short, making care harder to get doesn’t make healthcare work better.
Sometimes, it actually makes things worse.
The Burden is Even Heavier for People Already Facing Barriers
Not every patient faces the same challenges with paperwork. Imagine trying to navigate a complicated healthcare process if you have limited internet access, can’t take time off work, have trouble getting a ride, face language barriers, struggle to understand health information, or have no one to help with calls and forms.
Even a simple instruction like “contact your insurance company” can mean making several phone calls, waiting on hold, hearing unfamiliar terms, and not knowing what to do next. The healthcare system might offer a service on paper.
But if people cannot realistically get through the process, the care is not truly accessible.
There Is Progress, But Patients Need Support Now
The good news is that people are working to simplify paperwork. The Centers for Medicare & Medicaid Services (CMS) has set new rules to make prior authorization easier and to improve how information is shared between health plans, providers, and patients.
CMS specifically identifies reducing the burden on payers, providers, and patients, and preventing avoidable delays in care, as goals of these changes. Technology and new policies help, but they can’t fix every problem right away.
People and organizations are still needed to help patients understand their choices, find resources, complete steps, and keep going when things get complicated.
Access Means Making Healthcare Easier to Reach
At The Access to Health Foundation, we believe that improving healthcare access means more than just making sure a service exists. We also need to make sure people can actually use it.
Can people understand the process? Can they take the next step?
Reducing paperwork is about more than just cutting down on forms. It is about bringing people closer to the care they need.
Sometimes, the biggest barrier to healthcare is not the treatment. It’s everything that gets in the way of reaching it. Do you want to help us make a difference?
Every day, we work to improve health equality and invite you to help bring better care to more communities. Take a look at our four ways to support us and pick the one that fits you best.
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