HARTFORD – Aetna is setting the pace for prior authorization reform, moving faster and further than the industry to simplify access to care for patients and providers.
The company announced Friday that it has standardized 88% of its prior authorization volume—surpassing industry commitments—while continuing to require prior authorization for fewer medical services than any other national health plan.
"Aetna is proud to lead, and most importantly, to deliver better, faster care to people who need it," said Aetna president Steve Nelson. "Prior authorization should enable care, not delay it. We're modernizing the process with speed, transparency, and clinical judgment to benefit everyone we serve."
Aetna's industry-leading results reflect its continued momentum:
- Over 95% of eligible prior authorizations approved within 24 hours
- 83% processed in real time, exceeding AHIP's 2027 industry commitment of 80%
- More than 1 million provider calls eliminated through automation and digital tools
Beyond simplification, Aetna is redefining prior authorization by becoming the first national payer to integrate medical and pharmacy decisions into single, condition-specific reviews. Newly launched bundled prior authorization programs, including a comprehensive musculoskeletal offering, build on earlier cancer bundles and create a more seamless experience for patients and providers alike.
