Digitizing Prior Authorization Could Ease Burden on Patients and Providers

Major health insurers recently pledged to simplify and reduce prior authorization across commercial plans, Medicare Advantage and Medicaid managed care. Hari Prasad, CEO of Yosi Health, sees the move as a significant step forward for both patients and healthcare providers.

“This is a really welcome move by the health insurance plans, especially because this comes (as) voluntary,” Prasad said, adding that prior authorization delays have caused 74% of patients to abandon care in the past.

He added that streamlining the process could lead to faster treatment and better outcomes for patients, while also reducing stress on clinicians.

Founded in 2015, Yosi Health has focused on reducing administrative burdens in healthcare from the start. The company’s mission aligns closely with the insurers’ pledge, which also includes efforts to digitize the prior authorization process and enable real-time approvals.

Prasad shared that the current process often involves manual, paper-based or phone-based steps, causing delays and inefficiencies. By switching to digital systems, providers can avoid redundant paperwork, speed up care decisions, and track outcomes more effectively.

He also pointed to broader financial implications: with U.S. healthcare spending projected to reach $7.7 trillion by 2033, eliminating unnecessary administrative costs is becoming increasingly important.

The voluntary nature of the insurers' pledge adds to its impact, as it shows a willingness across the industry to address a known pain point in care delivery, he shared.

Prasad hopes this is the beginning of more industry-wide efforts that put patients and outcomes at the center of care processes.