Doctors Doubt Prior Authorization Improvement Promises

AMA recently conducted a prior authorization survey among its members. More than 60 health insurers, including UnitedHealthcare, Aetna, Cigna, Humana, Elevance Health, and Blue Cross Blue Shield Association, made a pledge last summer to make improvements to the prior authorization system. With a January 1, 2027 goal date, the health plans promised they will work toward the development and implementation of common, transparent submissions for electronic prior authorization. With added technology, they promised "seamless, streamlined processes and faster turnaround times." AMA found that only 1 in 3 doctors believe these insurers' promises. We summarized the finding below.

The report examines continued concerns about prior authorization in health care, focusing on whether insurers are meeting commitments to streamline and improve the process. Although more than 60 health insurers pledged in 2025 to reduce administrative burden, improve transparency, and modernize prior authorization over the next two years, the AMA’s 2025 physician survey shows that confidence remains low: only about one-third of physicians expect meaningful change for patients and doctors.

The survey findings suggest that prior authorization reforms have not yet produced noticeable improvements in daily clinical practice. Physicians report limited progress in areas insurers previously promised to address, including qualified medical review of denials, selective use of prior authorization, accurate communication of requirements, continuity-of-care protections, and electronic automation. For example, only 24% of physicians believe medical-necessity denials are reviewed by appropriately qualified physicians, and only 5% report access to exemption programs such as gold carding.

The report also emphasizes the patient harm and administrative burden associated with prior authorization. Physicians overwhelmingly say the process delays necessary care, worsens clinical outcomes, contributes to treatment abandonment, and in some cases leads to serious adverse events. The burden on practices is also substantial, with physicians completing an average of 40 prior authorizations per week, consuming roughly 13 hours of physician and staff time, and contributing to burnout, staffing costs, and broader health system inefficiencies.

Overall, the report concludes that voluntary insurer pledges have not yet restored physician or patient trust. The AMA argues that insurers must demonstrate sustained, transparent, and measurable action to reduce delays, protect patients, lower administrative burden, and make prior authorization more clinically focused and patient centered.

Click here to review the full AMA survey.