More than 50 major U.S. health insurers, including UnitedHealthcare, CVS Health, Cigna, Elevance Health, and Blue Cross Blue Shield, announced Monday they will streamline and reduce the controversial practice of prior authorizations, a process long criticized for delaying patient care and increasing administrative burdens on doctors. The effort will impact an estimated 257 million Americans covered under commercial, Medicare, and Medicaid health plans.
The announcement was led by AHIP, a trade group representing health plans, and the Blue Cross Blue Shield Association. Under the pledge, participating insurers agreed to implement a series of reforms to simplify the process by 2027. Among the commitments is a plan to ensure that at least 80% of electronic prior authorization requests with complete clinical documentation will receive real-time decisions by January 1, 2027.
In addition, the insurers aim to standardize electronic prior authorization submission formats and reduce the volume of treatments requiring prior authorization across markets by 2026. Patients changing insurers mid-treatment will also benefit from a 90-day transition period during which their prior authorizations will be honored.
"While this commitment is a step in the right direction, we will ultimately measure its impact by real changes in the day-to-day experiences of patients and the physicians who care for them," stated Shawn Martin, CEO of the American Academy of Family Physicians.
The move follows years of complaints from healthcare providers and patients over the bureaucratic hurdles associated with pre-treatment approvals. According to an American Medical Association survey, more than 80% of physicians reported that prior authorization issues led patients to abandon treatment, while nearly 90% said the process contributes to physician burnout.
This renewed industry-wide effort also comes months after the assassination of UnitedHealthcare CEO Brian Thompson drew national attention to the strained relationship between providers, patients, and insurers. While several insurers have taken independent steps to reduce prior authorization burdens in recent years, Monday's unified commitment marks the most sweeping industry initiative to date.
AHIP said the changes are designed to improve patient access to medically necessary treatments and reduce unnecessary delays, while also lowering the operational toll on doctors and hospitals-many of whom still rely on paper-based processes.
