Health plans report 11% reduction in prior authorization

Health plans participating in the industry’s commitment to reduce the number of prior authorizations so far have achieved an 11% reduction across a range of medical services, including a reduction of more than 15% in Medicare Advantage, finds a survey done by Blue Cross Blue Shield Association (BCBSA) and AHIP, the trade association representing the health insurance industry.

Services removed from prior authorization include those with clear, evidence-based clinical guidelines; demonstrated improvements in patient outcomes; and consistent utilization patterns among providers, AHIP leaders said in a news release.

But Bobby Mukkamala, M.D., president of the American Medical Association, told Managed Healthcare Executive that the burden of prior authorization remains high, with physicians reporting they complete an average of 39 prior authorization requests each week. “Announced reductions in the number of services subject to prior authorization are a positive first step, but physicians and patients must experience a meaningful, real-world decrease in administrative burden and care delays.”

In June 2025, more than 50 healthcare plans agreed to streamline, simplify and reduce the prior authorization process, according to leaders at the Department of Health and Human Services and AHIP. Plans such as Aetna, Cigna, UnitedHealthcare, Blue Cross Blue Shield and others had agreed on a set of six commitments. A full list of plans participating can be found here.

Related: Plans Agree to Prior Auth Reform. Physicians and Business Groups Want Measurable Results

“During the past 10 months, the Blues made significant, measurable strides toward delivering on our promise to make this process faster, simpler and more transparent,” Kim Keck, CEO of the Blue Cross Blue Shield Association, said in a news release. “Moving forward, we will focus on our commitment to address 80% of electronic prior authorization requests in real-time, at the speed of care.”

By January 2027, health plans will standardize electronic prior authorization, implementing common and transparent submissions, and expand real-time response for at least 80% of electronic prior authorization approval in 2027.

In separate announcements, Cigna and UnitedHealthcare executives said that both companies expect a more than 70% reduction in prior authorization volume by the end of 2026. Cigna has already reduced the overall volume of medical authorizations by about 15%, the insurer said in a recent transparency report. Aetna has announced the company has already standardized 88% of its prior authorization volume.

At UnitedHealth Group’s earnings call with investors earlier this week, the company highlighted some of its efforts in reducing prior authorization. “Nearly 95% of higher authorization requests are now submitted electronically. About 50% of those are processed in real time, and more than 90% are approved on average, in one business day,” Tim Noel, CEO of UnitedHealthcare, said during the call with investors.

UnitedHealthcare, he said, is working to enable more prior authorization submissions to be made directly within care provider workflows, and the plan is taking steps to further reduce the overall number of medical prior authorizations by 30% or more by the end of this year.

UnitedHealthcare has expanded its rural health initiative. By the fall of this year, the health insurer will have eliminated most medical prior authorizations. In January 2026, UnitedHealthcare launched its Rural Payment Acceleration Pilot in four states. Under the program, Medicare Advantage payments to hospitals were accelerated from fewer than 30 days to fewer than 15 days on average. The pilot is expanding to include five additional states: Alabama, Arkansas, Kentucky, Virginia and West Virginia. By the fall of 2026, UnitedHealthcare intends to have expanded this program to approximately 1,500 rural hospitals and their associated rural practitioners.

AI has become a big part of efforts to address the challenges of prior authorization. For example, UnitedHealthcare OptumRx’s PreCheck prior authorization capability now reduces prescription approval time from more than eight hours to under 30 seconds.