Doctors Skeptical of Insurers’ Pledges to Rein in Prior Authorization

Physicians remain skeptical that health insurers’ pledges to ease prior authorization hassles will result in any meaningful action, an American Medical Association (AMA) survey found.

In June 2025, a group of about 60 insurers said that they would standardize electronic prior authorization by the end of 2026 to help speed up the process. They also said they would reduce the scope of claims subject to medical prior authorization, and would honor the pre-approvals of a previous insurer for a window of time after someone switches plans.

The insurers also said they planned to expand the number of real-time responses, and that they would ensure that claims denied for clinical reasons will continue to get reviews by “medical professionals.” But they made no promises that those reviewers will be in the same specialty as the treating doctor, a common complaint from physicians.

“Ahead of the first major [2026] deadline, the AMA surveyed 1,000 practicing physicians to assess whether these commitments are likely to deliver meaningful improvements for patients and physicians,” the AMA explained Wednesday in a press release. “Findings from the … survey show that only one in three physicians (33%) believe the latest insurer pledge will make a meaningful difference.”

The survey consisted of 44 questions administered online in December 2025. Of the respondents, 40% were primary care physicians and 60% were specialists; all participants provide 20 hours or more of patient care each week.

Other findings from the survey included:

• A strong majority of physicians reported that the number of prior authorizations required for prescription medications and medical services has increased over the last 5 years (84% say that’s true for prescriptions, and 82% for medical services)
• A majority of physicians said that it is difficult to determine whether a prescription medication or medical service requires prior authorization (63% for prescriptions and 62% for medical services)
• More than one in four physicians (27%) reported that the drug prior authorization requirement information provided in their electronic health record or e-prescribing system is rarely or never accurate
• Nearly 90% of physicians said that prior authorization interferes with continuity of care
• More than one in four physicians (26%) reported that prior authorization has led to a serious adverse event, including hospitalization, permanent impairment, or death
• Physicians complete an average of 40 prior authorizations per week, and 32% reported that requests are often or always denied
• Prior authorization consumes an average of 13 hours of physician and staff time each week, and 40% employ staff dedicated exclusively for prior authorization tasks

Physicians also reported consistently high administrative burden with prior authorization across all major health insurers, the AMA noted. UnitedHealthcare (75%) tops the ranks for “high” or “extremely high” burden, followed by Humana (65%), Anthem/Elevance (61%), Aetna (61%), Cigna (59%), and Blue Cross Blue Shield (56%).

Several other prior authorization-related events have occurred since the survey was completed. Last month, the health plans that participated in the June 2025 announcement said that they have since eliminated 11% of prior authorizations across a range of medical services, “representing 6.5 million fewer prior authorizations for patients,” according to a press release from AHIP (formerly America’s Health Insurance Plans), a trade group for health insurers. “This reduction is helping to ease administrative burdens and speed access to evidence-based care. Health plans also affirmed improvements that make it easier for members who switch insurance to maintain their prior authorization approvals, known as continuity of care, and enhanced communications on prior authorization determinations.”

On May 5, UnitedHealthcare announced that by the end of 2026, it would eliminate authorization requirements for 30% of healthcare services that previously required insurer approval. Some of the services for which prior authorization will be eliminated include select outpatient surgeries, some diagnostic tests like echocardiograms, and certain outpatient therapies and chiropractic care, the company said, adding that a full list will be available on UHCProvider.com before these changes take effect.

The company also downplayed its use of prior authorization. “Today, prior authorization is required for only 2% of UnitedHealthcare medical services,” it said in the release. “Of the authorizations that are submitted, around 92% are approved and in less than 24 hours, on average. Within Medicare Advantage, UnitedHealthcare has fewer prior authorization requirements than any other insurer.”

On Tuesday, the Centers for Medicare & Medicaid Services (CMS) announced it had established an Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements in that area. A total of 29 organizations, “including health systems, electronic health record developers, physician practices, networks, and digital health developers — have signed on as early adopters in this cross-sector effort,” the agency said in a press release.

“Prior authorization won’t be fixed by technology alone. It requires the entire healthcare system to work together to solve real-world challenges,” CMS Administrator Mehmet Oz, MD, MBA, said in the release. “This work will help reduce administrative burden, giving clinicians more time to focus on patients and helping people get care faster.”