Making health insurance work better for providers

Administrative tasks and paperwork too often take time and energy away from patient care. With growing patient needs and a strained workforce, providers can feel like they’re spending more time navigating multiple systems and meeting documentation requirements than being with their patients. At Aetna, we know simplifying these processes is essential to supporting providers and helping them focus on what matters most: caring for their patients.

The toll of administrative complexity

AMA survey research from 2024 found that providers are spending a full workday’s worth of time (7.9 hours) each week on administrative tasks*. Administrative work has grown far beyond what most providers can manage. Clinicians spend hours each day entering data, submitting claims and coordinating prior authorizations, often across systems that don’t work well together.

This complexity can lead to frustration when simple tasks require extra steps. It is a major contributor to burnout, leading to physician turnover* and disrupting continuous care for patients.

How health plans can help

Our health care system is complex. Solving administrative overload can help health plans and providers accomplish their shared goal of improving and managing patients’ health — but it takes collaboration. 

Many health plans, like Aetna, are working to:
 

• Streamline prior authorization and claims workflows to cut down on paperwork and phone calls.

• Enhance digital tools so provider-health plan interactions are more convenient and real-time.

• Clarify requirements upfront so providers can complete transactions correctly the first time, minimizing back-and-forth.

• Proactively identify administrative issues like missing documentation or coding errors that could delay care — reducing follow-up tasks for providers and care delays for members.

The Aetna approach to supporting providers

Aetna knows that when providers have the right tools and support, they can spend more time with their patients. That’s why we are making targeted investments to reduce administrative burden.

Our commitment is to partner with providers by simplifying the areas that drive administrative burden: Prior authorization, claims workflows, digital tools and clear upfront requirements. Here’s a few examples of how we’re doing it:

• Making prior authorization requirements more targeted. Aetna has long been committed to reviewing and refining which services require prior authorization. We work to reduce the number of services subject to prior authorization and support smoother care transitions. This ongoing effort reflects our own standards for improving the experience and aligns with broader industry commitments through AHIP*.

• Removing friction by bundling prior authorization. Bundling allows multiple requests for related services to be approved at once, so there's less administrative management required for one treatment plan. In 2025, Aetna began bundling prior authorizations for certain conditions, allowing a single request to approve a series of related future tests and interventions. These began in lung, breast and prostate cancer to cover entire pathways of current and future screenings. Aetna has since expanded bundles to other procedures and has begun bundling prior authorizations across pharmacy prescriptions and medical procedures for in vitro fertilization.

• Speeding up prior authorization decisions. Across the insurance industry, Aetna has the fewest medical services subject to prior authorization — about half as many as our nearest competitor. As of February 2026, we approve more than 95% of all eligible prior authorizations within 24 hours, with many completed instantaneously. We currently approve 77% of electronic prior authorizations in real-time, and we will exceed 80% by the end of 2026.

• Simplifying claims workflows. Aetna is streamlining claims submissions so claims can be processed more quickly and providers spend less time on rework.

• Clarifying requirements up front and getting ahead of potential issues. Aetna aims to make documentation and coverage requirements easier to understand from the start, minimizing back-and-forth and helping providers complete transactions right the first time. In addition, through programs like Aetna Clinical Collaboration (ACC), nurses help coordinate transitions of care, explain benefit options and organize follow-ups — reducing the administrative work on providers’ plates.

• Upgrading and consolidating digital tools so more interactions can be handled online. Aetna is enhancing digital portals so providers can check eligibility, track prior authorization status and resolve common questions in real time, reducing manual work and follow-up calls.

These initiatives help to remove barriers, which can lead to a better provider experience with health plans and reduce the administrative side of managing their patients.

Looking ahead

Reducing administrative complexity is central to supporting providers — and it’s an ongoing commitment at Aetna. Fewer administrative demands can mean less stress and reduced burnout. For patients, it can lead to more engaged providers and better care coordination. And for the health system overall, fewer hurdles can drive greater efficiency, lower costs and stronger payer-provider relationships.

Alongside these efforts, Aetna is expanding value-based care partnerships. These models reward quality and coordination over volume — aligning incentives and enabling care teams to focus more time and resources on patients, which supports better outcomes tied to value-based care models for our members*.

We are dedicated to listening to providers, learning from their experiences and making continuous improvements that ease the demands of day-to-day practice. Less time on paperwork means more time for meaningful patient care — and our investments are helping make that future possible.