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Aetna reports 88% standardization of prior authorization volume

April 27, 2026 9:10 AM

Aetna, a CVS Health company (NYSE: CVS), announced it has standardized 88% of its prior authorization volume and processes 95% of eligible prior authorizations within 24 hours, according to a company statement.

The health insurer said 83% of prior authorizations are processed in real time, surpassing the America's Health Insurance Plans 2027 industry commitment of 80%. Aetna reported eliminating more than 1 million provider calls through automation and digital tools.

"Prior authorization should enable care, not delay it," said Aetna President Steve Nelson in the statement. "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 programs include a musculoskeletal offering that builds on earlier cancer bundles.

Aetna serves approximately 37 million people and offers health insurance products including medical, pharmacy, dental and behavioral health plans. CVS Health operates approximately 9,000 retail pharmacy locations and more than 1,000 walk-in and primary care medical clinics as of December 31, 2025.

The company stated it maintains the fewest medical services requiring prior authorization among national health plans, though specific comparative data was not provided.

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