Major U.S. Insurers Commit to Streamlining Prior Authorization by 2027

Major U.S. health insurers including Blue Cross Blue Shield, Humana, Cigna, and UnitedHealthCare have committed to streamlining and simplifying the prior authorization process across commercial, Medicare, and Medicaid plans. This initiative, coordinated through the industry trade group AHIP, aims to address inefficiencies in prior authorization workflows, which currently contribute to delays in medically necessary care and add administrative burden for healthcare providers. The changes are designed to improve patient access to services while alleviating provider clerical workloads.

Under the new commitment, by early 2027, insurers plan to adopt a common electronic prior authorization standard that will enable real-time responses for at least 80% of authorization requests. Additionally, by 2026, individual health plans will reduce the number of claim types requiring prior authorization. These reforms signal a move towards modernization and greater automation within the health insurance authorization process.

Health industry leaders emphasize that the prior authorization process will remain in place, but reformed to better serve providers and patients. The changes are expected to benefit approximately 257 million Americans covered under varied insurance markets. The efforts reflect a broader push from insurers to enhance operational efficiency and reduce provider burnout caused by cumbersome manual procedures.

The reform initiative has garnered support from medical professional organizations such as the American Academy of Family Physicians, which highlights the importance of reforms in ensuring timely access to care and reducing administrative hurdles. The participating insurers are scheduled to discuss the ongoing process and implementation with senior officials from the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services, indicating government engagement on this industry-wide effort.

This commitment to streamline prior authorizations could have broad implications for payer-provider interactions, regulatory compliance, and patient care coordination. By modernizing and standardizing prior authorization workflows, insurers aim to accelerate approvals and reduce bureaucratic delays, potentially setting a new industry standard for healthcare administrative processes. The initiative aligns with ongoing trends of increasing digitization and process automation within healthcare insurance operations.