Hedy Jarwono

Leading health plans plan one electronic prior authorization approach for commonly reviewed medical services, aiming for faster patient answers and less provider paperwork.
The standards will cover services like orthopedic surgeries, CT scans, and MRIs across commercial and public managed-care coverage categories used by plans.
Clinical policies and coverage decisions stay plan-specific, so standardization targets request submission, not how individual plans decide patients’ care eligibility in practice.
A related voluntary initiative has already included prior authorization volume ↓11%, reinforcing momentum behind broader administrative simplification for providers, plans, and patients.
Provider groups and technology partners are giving feedback on data requirements, supporting broad adoption as rolling implementation begins Jan. 1, 2027, over time.

Health Plans Standardize Prior Authorization

Economic uncertainty, shifting demographics, innovation, and higher consumer expectations are reshaping how Americans evaluate financial security and long-term protection through life insurance choices.
Providers are prioritizing simpler, more relevant solutions, pairing coverage with advice around fertility, cognitive decline, caregiving, and broader financial wellness needs today.
Consumers increasingly research, compare, and buy coverage by smartphone, pushing providers to improve digital access while preserving trusted, relationship-based guidance for decisions.
AI and data analytics are speeding underwriting and risk assessment, helping providers anticipate needs and deliver tailored, seamless insurance experiences more consistently.
Closing the protection gap now depends on personalized partnerships, simpler explanations, and solutions that better fit consumers’ real-life needs throughout their lifetimes.