Health insurers move to streamline prior authorization process, promising quicker care
Major U.S. Health Insurers Simplify Prior Authorization Process
UnitedHealthcare, Kaiser Permanente, and other leading health insurers in the United States are taking steps to streamline the prior authorization process to make it faster and easier for patients to access care. The announcement was made by the Health Insurance Plans (AHIP), a trade association representing the industry, on Monday.
Prior authorization, the process through which healthcare providers obtain approval from patients’ insurance carriers to deliver care, has been known to be time-consuming for doctors, leading to frustrating delays for patients in receiving essential medical treatment. According to a survey by the American Medical Association, physicians’ offices spend an average of 12 hours per week seeking approval for services from insurers, which hampers their ability to focus on providing care.
As part of the new agreement, participating insurers have committed to implementing measures to expedite the sluggish prior authorization process. This includes establishing a standardized online system for submitting prior authorization requests, reducing the number of claims subject to prior authorization, and improving real-time responses to requests. These changes are set to take effect between 2026 and 2027.
Mike Tuffin, CEO of AHIP, emphasized the need for a more seamless patient experience and modernizing the system to enable providers to concentrate on patient care. Shawn Martin, CEO of the American Academy of Family Physicians, lauded the initiative as a step in the right direction, highlighting the importance of assessing its impact on patients and physicians.
Dozens of insurers, including state Blue Cross and Blue Shield plans, as well as some Medicare and Medicaid plans, have signed onto the commitment. AHIP estimates that over 250 million Americans could benefit from the joint effort to improve prior authorization.
The list of signatories includes major insurers such as AmeriHealth Caritas, Kaiser Permanente, Humana, UnitedHealthcare, and others. These insurers are collectively working towards creating a more efficient and patient-centered healthcare system.
Author
Mary Cunningham is a reporter for CBS MoneyWatch. Before joining the business and finance vertical, she worked at “60 Minutes,” CBSNews.com, and CBS News 24/7 as part of the CBS News Associate Program.
