Major U.S. health insurers say they will streamline controversial process for approving care

In a move that could bring relief to millions of patients and healthcare providers, major U.S. health insurers have announced plans to streamline the prior authorization process a step that could reduce care delays and administrative headaches.

Prior authorization is the insurance industry’s way of requiring doctors to get approval before providing certain treatments or services. While insurers argue this helps manage costs and ensures appropriate care, patients and providers have long criticized the process for causing frustrating delays, denied claims, and contributing to physician burnout.

On Monday, dozens of health plans from top insurers including CVS Health, UnitedHealthcare, Cigna, Humana, Elevance Health, and Blue Cross Blue Shield voluntarily committed to improving how prior authorizations are handled. The announcement came from AHIP, the national association representing health plans.

These improvements will roll out across different types of insurance, including commercial plans, Medicare, and Medicaid, and are expected to benefit up to 257 million Americans.

Key Changes Coming

Here’s what insurers plan to do:

• By 2026: Reduce the number of treatments and services that require prior authorization.
• By 2027: Adopt a shared standard for submitting prior authorization requests electronically.
• Also by 2027: Ensure that 80% of electronic requests with complete documentation are processed in real time.

This would be a huge shift from the current process, where many requests are still submitted using manual paperwork, slowing everything down.

Why Now?

The move comes after a wave of public criticism earlier this year, especially following the tragic death of Brian Thompson, CEO of UnitedHealthcare. The incident sparked renewed debate about how insurance companies handle patient care.

While some companies have already taken steps to modernize their systems, this industry-wide effort is designed to create more uniform, faster, and simpler processes for everyone involved.

Hope from the Medical Community

Healthcare leaders are hopeful the changes will lead to real improvements. Shawn Martin, CEO of the American Academy of Family Physicians, said in the release,

“We look forward to collaborating with payers to ensure these efforts lead to meaningful and lasting improvements in patient care.”

You may also like

How to Buy Stocks in Today’s Unpredictable Market

In short, insurers are finally addressing what doctors and patients have been complaining about for years and if these changes are implemented well, it could make getting care faster, easier, and far less stressful for everyone.