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Holding to a health insurance industry commitment to reduce the need for prior authorization, CVS Health\u2019s Aetna health insurance unit said Thursday it will \u201cintegrate pharmacy prescriptions and medical procedures into a single clinical review.\u201d Aetna’s CEO Steve Nelson is speaking about some of the health insurer’s business practices centered around improving patient experience at the Forbes Healthcare Summit December 4, 2025 in New York. In this photo, Snow covers the ground around Aetna Inc. signage displayed outside of the company’s corporate headquarters in Hartford, Connecticut, U.S., on Friday, Feb. 6, 2015. (Photographer: Ron Antonelli\/Bloomberg)<\/p>\n
\u00a9 2015 Bloomberg Finance LP<\/p>\n
Holding to a health insurance industry commitment to reduce the need for prior authorization, CVS Health\u2019s Aetna health insurance unit said it will \u201cintegrate pharmacy prescriptions and medical procedures into a single clinical review.\u201d<\/p>\n
The health insurer\u2019s president Steve Nelson, who will speak Thursday afternoon at the annual Forbes Healthcare Summit, will outline an array of business industry practices that are changing for the nation\u2019s third-largest health insurer<\/a> to improve health outcomes and the patient experience. <\/p>\n \u201cWe\u2019re moving away from a transactional mindset to a consumer-driven solutions mindset,\u201d Nelson said in an interview ahead of the summit. <\/p>\n Part of the Aetna effort involves \u201cbundling prior authorizations\u201d within the health plan enrollee\u2019s medical benefit, so they only need a single prior authorization once diagnosed with a specific condition. <\/p>\n \u201cAetna committed to several bold actions earlier this year intended to improve the American healthcare industry and I\u2019m proud of the progress we\u2019ve made against these commitmemts,\u201d Nelson said in a statement outlining some of Aetna\u2019s new business practices centered around patient experience. \u201cWorking in partnership with stakeholders across the industry, I am optimistic that we can achieve our shared purpose of simplifying the healthcare system to make it easier for consumers to navigate healthcare and access affordable, personalized solutions.\u201d<\/p>\n Earlier this year, Aetna was among the biggest names in health insurance, including Cigna, UnitedHealth Group\u2019s UnitedHealthcare and Humana and more than 50 health insurers that committed to \u201cstreamline<\/a>, simplify and reduce\u201d prior authorization, the process of insurers reviewing hospital admissions and medications.<\/p>\n The sweeping commitments were announced this past summer by America\u2019s Health Insurance Plans<\/a>, also known as AHIP, and the Blue Cross Blue Shield Association, which have health plan members that provide health benefits to more than 250 million Americans. They said they \u201caim to accelerate decision timelines, increase transparency and expand access to affordable, quality care.\u201d<\/p>\n Doctors complain prior authorization has delayed needed treatment and put patient health in jeopardy while wasting physician and patient time to jump through hoops. Over the past several years, prior authorization increasingly has become a concern for patient access to needed services, according to almost 30% of physicians responding to an American Medical Association survey<\/a> in 2023.<\/p>\n In Aetna\u2019s case, the health insurance giant Thursday said its first bundling approach across the medical and pharmacy benefit will be for women seeking in vitro fertilization (IVF) and will eventually be rolled out to more conditions and diseases. \u201cProviders simply file the medical PA, and if approved, the associated medications covered under the Aetna pharmacy benefit are automatically approved,\u201d Aetna said in a statement announcing the new approach to prior authorization.<\/p>\n","protected":false},"excerpt":{"rendered":"Holding to a health insurance industry commitment to reduce the need for prior authorization, CVS Health\u2019s Aetna health…\n","protected":false},"author":2,"featured_media":331846,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":{"0":"post-331845","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/331845","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=331845"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/331845\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/331846"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=331845"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=331845"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=331845"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}