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News » UnitedHealth to cut red tape in health insurance approval processes

UnitedHealth to cut red tape in health insurance approval processes

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Photo from The Associated Press

MINNESOTA, UNITED STATES — UnitedHealth Group, the largest health insurer in the U.S., has revealed plans to ease prior authorization requirements for its Medicare Advantage (MA) plans. 

CEO Andrew Witty shared the initiative during the company’s fourth-quarter earnings call, underscoring the need for a more efficient and patient-friendly healthcare system.

“We’re eager to work with policy leaders to use standardization and technology to speed up turnaround times for approval of procedures and services for Medicare Advantage patients,” Witty stated. He also emphasized reducing the overall number of prior authorizations required for certain services.

The announcement follows mounting criticism from providers, policymakers, and patients over delays caused by prior authorization processes. While specific details remain sparse, Witty assured stakeholders that UnitedHealthcare is “very close” to rolling out a new initiative aimed at streamlining these requests.

Vision for simplified approvals

Witty highlighted the importance of collaboration across the healthcare industry to design solutions that benefit all stakeholders. “The health system needs to function better—it needs to be less confusing, less complex, and less costly,” he said.

This initiative builds on UnitedHealthcare’s October 2023 launch of a “gold card” program, which reduced prior authorization requirements for select providers and procedures. However, skepticism persists among stakeholders about whether these efforts will sufficiently address systemic inefficiencies.

Witty’s recent remarks align with his op-ed in The New York Times, where he acknowledged the role insurers like UnitedHealthcare have played in contributing to a healthcare system that many patients find difficult to navigate.

“We understand and share the desire to build a healthcare system that works better for everyone. That is the purpose of our organization,” Witty wrote. Still, he admitted that achieving meaningful reform remains a significant challenge.

Growing pressure over prior authorization practices

UnitedHealth’s announcement comes amid broader industry scrutiny. Insurers like Cigna, Humana, and Aetna have also pledged reforms in response to provider complaints about increasing prior authorization demands. Policymakers have taken notice as well; Congress debated bipartisan legislation last year to limit these practices, while several states enacted laws targeting them. 

Additionally, the Centers for Medicare and Medicaid Services (CMS) proposed new rules in November aimed at curbing excessive prior authorization requirements.

According to research from KFF, prior authorization denials have risen sharply in recent years. In 2022 alone, MA plans rejected 7.4% of 46 million requests—up from 5.7% in 2019—highlighting the growing burden on patients and providers alike.

Financial challenges and market growth for UnitedHealth

Despite these challenges, UnitedHealth remains a dominant force in the Medicare Advantage market. The company added approximately 800,000 enrollees during the 2023 annual enrollment period, bringing its total MA membership to 7.8 million—a 1.9% increase year-over-year.

However, financial pressures persist as UnitedHealth reported a 34.1% decline in net profit during the fourth quarter due to rising medical costs and other factors. The company’s medical loss ratio increased from 83.2% in 2023 to 85.5% in 2024, reflecting higher spending on care.

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