Patients Turn to Social Media to Advocate for Denied Treatments
Patients across the United States are increasingly turning to social media platforms like Facebook and Instagram to publicly shame health insurance companies that deny coverage for essential treatments. Frustrated by long and complicated prior authorization processes, patients and even physicians are taking to social media to share their experiences and rally for change.
One such patient is Sally Nix from Statesville, North Carolina. Nix suffers from autoimmune diseases that have been resistant to traditional treatments. However, intravenous immunoglobulin infusions, commonly known as IVIG, proved to be highly effective in alleviating her chronic pain and fatigue. When Nix’s health insurer started denying payment for the treatment, she took to social media to express her outrage and share her struggle.
The process of prior authorization is often employed by health insurers as a cost-cutting measure. It requires patients and doctors to seek approval before proceeding with tests, procedures, or prescription medications. Insurers argue that it helps control costs by preventing unnecessary care. However, patients argue that these rules create obstacles that delay or deny access to much-needed treatments. In some cases, these delays and denials can have severe consequences, including death.
Aware of the power of social media for advocacy, patients like Nix and even physicians have resorted to publicly shaming insurance companies to secure approval for tests, drugs, and treatments. Shehzad Saeed, a pediatric gastroenterologist at Dayton’s Children’s Hospital in Ohio, tweeted a photo of a skin rash caused by Crohn’s disease, blaming Anthem for denying the biologic treatment his patient required.
While the federal government has proposed reforms to increase transparency and speed up response times for prior authorization, these changes would only affect certain categories of health insurance, leaving roughly half of all Americans without the benefits. Some patient advocates and health policy experts argue that insurers may be exploiting prior authorization as a loophole to avoid covering patients with high healthcare costs.
Although healthcare companies are increasingly engaging with unhappy customers online, it remains unclear how effective social media activism is in reversing prior authorization denials. However, some major insurers have voluntarily revised their prior authorization policies to ease preapproval mandates for doctors and patients. Additionally, many states are passing laws to limit the use of prior authorization.
While social media may not be the ultimate solution, it has proven to be a powerful tool for patients to voice their grievances and put pressure on insurers to reconsider their decisions. It is a testament to the growing influence of digital platforms in shaping the future of healthcare. As patients continue to advocate for their rights, insurers and policymakers are being urged to find a balance that ensures timely access to vital treatments while controlling costs.
In the case of Sally Nix, her public outcry on social media caught the attention of her insurer, Blue Cross Blue Shield of Illinois. After KFF Health News contacted the insurer, Nix discovered that a significant portion of her outstanding claims had been marked as paid on the company’s online portal. Furthermore, she was informed that prior authorization would no longer be required for her infusions. While relieved, Nix expressed that this resolution should not have required such an effort.
As the healthcare landscape evolves, patients are increasingly relying on the power of social media to shed light on their struggles and advocate for change. Whether it is pressuring insurers to reconsider denials or urging policymakers to reform prior authorization practices, these patient-driven efforts are shaping the future of healthcare and working towards a system that prioritizes patients’ needs and accessibility.
