AMA Survey: Prior Authorization Reform Pledge Falls Short with Physicians

Only one in three physicians believe the latest insurer pledge will make a meaningful difference

CHICAGO, May 13, 2026 (GLOBE NEWSWIRE) -- Despite last summer’s widely publicized insurer pledge to improve prior authorization, new survey data from the American Medical Association (AMA) show physicians are pervasively skeptical that meaningful change will occur—reflecting years of similar commitments that have failed to produce lasting improvements.

In June 2025, after successful engagement from the Trump administration to address widespread concerns from patients and physicians, roughly 60 health insurers pledged to streamline, simplify, and reduce prior authorization requirements, with implementation deadlines spanning 2025 through 2027. Ahead of the first major deadline, the AMA surveyed 1,000 practicing physicians to assess whether these commitments are likely to deliver meaningful improvements for patients and physicians.

Findings from the 2025 AMA Prior Authorization Physician Survey show that only one in three physicians (33%) believe the latest insurer pledge will make a meaningful difference.

Physician skepticism is grounded in experience. As part of the 2025 pledge, insurers committed to ensuring that all medical necessity denials would be reviewed by a licensed and qualified clinician. Yet only one in four physicians (24%) report that such reviews are consistently conducted by appropriately qualified clinicians. In addition, just 16% of physicians who participate in peer-to-peer reviews say the health plan representative often or always has the appropriate qualifications.

“Physician trust in voluntary insurer pledges is deeply eroded after years of unfulfilled promises,” said AMA President Bobby Mukkamala, M.D. “Physicians are especially frustrated when so-called peer-to-peer reviews are conducted by individuals who lack the appropriate clinical expertise to evaluate a patient’s care. When only a third of physicians expect meaningful impact—and so few report that health plan reviewers are appropriately qualified—it highlights a credibility gap that won’t be closed with vague or partial measures. Rebuilding trust will require sustained, transparent, and measurable action to streamline prior authorization and keep it clinically focused and patient-centered. Anything less risks reinforcing the skepticism these pledges were meant to address.”

The AMA survey shows how much work insurers still must do and highlights ongoing concerns that prior authorization delays care, disrupts treatment, and harms patient outcomes.

• Patient Harm — More than one in four physicians (26%) report that prior authorization has led to a serious adverse event, including hospitalization, permanent impairment, or death.
• Delayed Care — More than nine in 10 physicians (95%) say prior authorization delays access to necessary care.
• Disrupted Care — Nearly four in five physicians (79%) report that patients abandon treatment due to authorization challenges.
• Poor Outcomes — More than nine in 10 physicians (92%) say prior authorization negatively affects clinical outcomes.

Prior authorization also continues to place significant strain on physician practices, driving high volumes of requests and denials, consuming clinical and administrative time, and contributing to widespread burnout. As administrative demands intensify, resources are increasingly diverted from patient care to manage an inefficient process.

• Added Burden — Physicians complete an average of 40 prior authorizations per week, and nearly one in three (32%) report that requests are often or always denied.
• Physician Burnout — More than nine in 10 physicians (94%) say prior authorization contributes to burnout.
• Denial Trend — Three-quarters of physicians (74%) report that denials have increased over the past five years, and six in 10 express concern that augmented intelligence (AI) may further increase denial rates.
• Diverted Time and Resources — Prior authorization consumes an average of 13 hours of physician and staff time each week, and two in five physicians (40%) employ staff dedicated exclusively to prior authorization tasks.

Beyond its impact on patients and physician practices, prior authorization also drives inefficiencies and unnecessary costs across the health system.

• Wasted Health Resources — More than four in five physicians (88%) report that prior authorization increases overall health care utilization, contributing to waste rather than savings. Physicians cite ineffective initial treatments (75%), additional office visits (73%), urgent or emergency care (47%), and hospitalizations (32%) as consequences of prior authorization requirements.

Physicians also report consistently high administrative burden with prior authorization across all major health insurers. 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%).

The AMA continues to work on every front in support of prior authorization reforms that prioritize patients’ access to necessary care and reduce administrative burdens for physicians. The AMA looks forward to continuing to work with the Trump administration, Congress and health insurers on this critical issue. To learn more about prior authorization challenges experienced by patients, physicians, and employers, go to FixPriorAuth.org.

AMA Media & Editorial
American Medical Association 
312-464-4430
media@ama-assn.org

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