Prior Authorization Metrics Provide New Insights into Insurer Practices, but Gaps Remain Authors: Michelle Long, Jeannie Fuglesten Biniek, Justin Lo, Rayna Wallace, Jada Raphael, Allison Kim, and Kaye Pestaina

https://www.kff.org/patient-consumer-protections/prior-authorization-metrics-provide-new-insights-into-insurer-practices-but-gaps-remain/ This analysis of available 2025 prior authorization data finds insurers denied at least 1 in 8 standard requests for prior authorization across three insurance markets: Medicare Advantage, Medicaid managed care, and the federally facilitated ACA Marketplaces. Denial rates varied wide segments by insurer. The analysis highlights limitations of the data and challenges for consumers interpreting it.