Denying and Delaying Indicated Care: The True Cost.

J Bone Joint Surg Am · Oct 01 2026 · Recent

Lee MY, Mazmudar AS, Rajput R, Kurup S, Yettapu D, Park DK, et al.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois

General Orthopaedics

SUMMARY — THE REDUCTIONThis commentary argues that denying or delaying indicated surgery through prior authorization does not save money but shifts costs onto patients through prolonged conservative care, lost work, and worse outcomes.
Abstract, as published

Cost in health care is not simply the dollar amount of a transaction. When a claim for indicated surgery is denied or delayed, savings are not guaranteed and patient outcomes likely worsen. Delays resulting from prior authorization create an administrative burden, and patients bear the burden of prolonged conservative care, lost workforce participation, and added psychological toll. Delaying or denying indicated surgery does not reduce cost; it simply redistributes it.

Featured in the 2026-10-02 issue.

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