A recent survey conducted by the American Medical Association (AMA) reveals significant skepticism among physicians regarding the effectiveness of a pledge made by insurance companies to reduce the burdens associated with prior authorizations. The survey, which polled 1,000 physicians in December 2025, indicated that only a third of the respondents believe that the actions taken by payers since last summer will lead to meaningful change.
One of the primary concerns expressed by the physicians stems from their direct interactions with health plan representatives. A mere 24% of respondents reported that prior authorization reviews are consistently conducted by qualified clinicians, while only 16% said that insurer representatives typically possess the necessary credentials during peer-to-peer reviews.
AMA President Bobby Mukkamala, M.D., emphasized the erosion of physician trust in voluntary insurer commitments following years of unmet expectations. He stated that rejuvenating trust requires transparent and measurable action focused on streamlining prior authorization processes while prioritizing clinical relevance and patient care. Without such commitments, any pledge risks reinforcing the skepticism it aims to mitigate.
In June 2025, leading insurance organizations, including AHIP and the Blue Cross Blue Shield Association, along with several major publicly traded payer firms, signed a pledge aimed at reducing the number of services subject to prior authorization. The initiative also focused on promoting electronic submissions for prior authorizations, which are believed to expedite response times. A report released in April indicated that payers have achieved an 11% reduction in prior authorizations under this pledge.
Despite these claims, physicians consistently reported high administrative burdens imposed by major insurers, with UnitedHealthcare receiving the most significant complaints. Physicians indicated they handle an average of 40 prior authorization requests weekly, with 32% of these submissions facing either frequent or consistent denial. An overwhelming 94% of surveyed doctors acknowledged that this administrative load contributes to physician burnout.
The survey uncovered a growing concern among physicians regarding rising denial rates. Seventy-four percent reported an increase in denials over recent years, and 60% expressed apprehension that advancements in artificial intelligence (AI) may exacerbate this issue.
Additionally, many physicians cited confusion regarding when prior authorization requests are necessary and highlighted a lack of technological support for transitioning to electronic submissions. Approximately 63% found it challenging to determine the need for authorization regarding medications, and 62% echoed similar sentiments for medical services. Over a quarter of the physicians (27%) indicated that the information provided related to authorization requirements through electronic health records or e-prescribing platforms is often inaccurate.
The traditional method of completing prior authorization requests remains prevalent, with phone calls being the primary means of submission for medical services. Just 24% of physicians reported the ability to submit electronic requests via their EHR for medications.
As part of the payer pledge, insurers committed to standardizing electronic prior authorization processes and increasing real-time responses. Recent developments indicate that some health systems, EHR vendors, and data platforms are now focused on enhancing the efficiency of prior authorization, but doubts about their effectiveness remain prevalent within the physician community.
