Prior authorization Trends & Statistics
UnitedHealth’s earnings surge calms a nervous Wall Street
By cutting unprofitable members to restore margins and investing in AI to boost efficiency, UnitedHealth’s strategy offers insurers a 2026 survival guide.
Insurers' 11% cut in prior authorizations isn't enough to ease their critics
Health plans reduced prior authorizations by 11%, but pressure on insurers remains as the changes risk seeming cosmetic without clear impact on clinicians and patients.
Pharma Marketing at the Point-of-Care
Pharma marketing is moving into the clinical workflow. As digital tools embed messaging across exams, telehealth, and pharmacies, brands can shape decisions in the moment—if they balance personalization with compliance and measurable results.
Insurers face heat over rising costs as UnitedHealth pledges ACA rebates
UnitedHealth will issue ACA refunds, but the move mirrors industry pledges—headline-friendly and light on accountability.
Prior authorizations lead to delayed or denied care for many consumers
The trend: Over half of US adults with health insurance (51%) said they needed a prior authorization for a medical service or treatment in the past two years, according to a July 2025 KFF study. The final word: Prior authorizations can lead to delayed—or even denied—care. To date, health plans have not been held accountable for their increased frequency of coverage denials. That could soon change due to a flurry of bills on prior authorization reform at the state level—but for the time being, insurers’ promises and pledges are more PR spin than actionable improvement.
Health insurers’ voluntary pledge to simplify prior authorization is unlikely to have a major impact
The news: Around 50 health plans— including large players UnitedHealthcare, CVS Health, Cigna, and Elevance Health—are pledging to simplify the prior authorization process. Our take: But their commitments don’t come with mandates or enforcement—meaning insurers can still get away with tactics that boost their profits over paying for expensive medical care.
Payers and software companies are expediting the prior authorization process
Blue Shield of California, Salesforce partner to streamline the prior authorization process: But denial rates are soaring. So, things aren’t going to get materially better since insurers are often better off denying expensive treatments.
Biden Administration issues final rules bolstering mental healthcare parity law
Biden Administration’s final rules aim to boost mental healthcare parity law: But with no new enforcement mechanisms in place, we’re bearish on their ability to improve patients’ access to mental healthcare in a meaningful way.
Powerful data and analysis on nearly every digital topic.
Become a ClientWant more marketing insights?
Sign up for EMARKETER Daily, our free newsletter.
Thanks for signing up for our newsletter!
You can read recent articles from EMARKETER here.- Learn about what technologies are transforming your industry
- Gain exclusive perspectives from top industry leaders
- Access thousands of data sets and forecasts via our iconic charts