Development of the Burden of Prior Authorization of Psychotherapeutics (BoPAP) Scale to Assess the Effects of Prior Authorization Among Texas Medicaid Providers

Abstract

This study describes an instrument to measure the perceived effects of prior authorization on quality of care among Texas Medicaid patients with severe mental illness. A questionnaire was mailed to 1,650 prescribers of psychiatric medications and 226 responses were used for analyses (17.5% response rate). Factor analysis revealed a 3-factor, 25-item instrument (BoPAP scale). Overall, prescribers reported a moderate burden of PA (BoPAP Mean = 3.90 +/- 0.52, possible range = 1-5). They perceived a high burden (4.49 +/- 0.57) on "administrative issues," a moderate burden (3.93 +/- 0.66) on "patient care processes/outcomes" and the lowest burden (3.30 +/- 0.74) on "system/societal costs." BoPAP scores differed based on provider characteristics, indicating evidence of discriminant validity.