U.S. Health Insurers Step Up Prior Authorization Reforms Amid Industry Pressure

Dow Jones
04/24
 

By Connor Hart

 

U.S. health insurers are accelerating efforts to streamline prior authorization requirements, with UnitedHealthcare and Aetna on Friday detailing progress toward industry commitments aimed at reducing administrative burdens and speeding patients' access to care.

UnitedHealthcare said more than half of its prior authorization volume will be incorporated into a standardized electronic submission process, with that share expected to exceed 70% by the end of 2026.

And Aetna, a unit of CVS Health, said it has already standardized 88% of its prior authorization volume. The company also said it is processing 83% of requests in real time, ahead of a 2027 goal set by insurers, and that more than 95% of eligible requests are approved within 24 hours.

Both companies emphasized the use of automation and digital tools to reduce administrative friction for providers. Aetna said it has eliminated more than 1 million provider calls through automation, while UnitedHealthcare highlighted efforts to reduce documentation requirements and limit the need for follow-up information.

The updates come as insurers face sustained scrutiny over prior authorization practices that can delay or block necessary care, The Wall Street Journal previously reported. The industry pledged last year to standardize electronic submissions and deliver at least 80% of decisions in real time by 2027, part of a broader push to ease administrative burdens and improve transparency.

 

Write to Connor Hart at connor.hart@wsj.com

 

(END) Dow Jones Newswires

April 24, 2026 08:07 ET (12:07 GMT)

Copyright (c) 2026 Dow Jones & Company, Inc.

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