Aetna standardizes 88% of prior authorization volume, exceeds industry goals

Aetna, a CVS Health company (NYSE: CVS), announced it has standardized 88% of its prior authorization volume and processes 83% of eligible requests in real time, according to a company statement.

The health insurer reported that more than 95% of eligible prior authorizations are approved within 24 hours. The company said it has eliminated more than 1 million provider calls through automation and digital tools.

Aetna's real-time processing rate of 83% exceeds the America's Health Insurance Plans 2027 industry commitment of 80%. The company stated it maintains the fewest medical services requiring prior authorization among national health plans.

"Prior authorization should enable care, not delay it," said Aetna President Steve Nelson. "We're modernizing the process with speed, transparency, and clinical judgment to benefit everyone we serve."

The company launched bundled prior authorization programs that integrate medical and pharmacy decisions into single, condition-specific reviews. The new offerings include a musculoskeletal program that builds on existing cancer bundles.

Aetna serves an estimated 37 million people and offers medical, pharmacy, dental and behavioral health plans. The company is part of CVS Health, which operates approximately 9,000 retail pharmacy locations and more than 1,000 walk-in and primary care medical clinics as of December 31, 2025.

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