In a report published Aug. 5, KFF examined data submitted to CMS by Medicare Advantage insurers in 2022.
The number of denials increased slightly from 6% in 2021. CVS Health denied the highest percentage of prior authorization requests in 2021 and 2022. The company denied 13% of prior authorization requests it received in 2022, up from 12% in 2021.
Humana had the highest number of prior authorization requests per member in 2022, at 2.9.
Here’s how major MA insurers compare on the number of prior authorizations and denial rates:
Average number of prior authorization requests per member (2022)
Humana: 2.9
Elevance Health (Anthem): 2.6
Anthem BCBS plans: 2.3
Centene: 2.2
Other BCBS plans: 2.0
All other plans: 2.0
CVS Health: 1.1
Cigna: 0.9
UnitedHealthcare: 0.9
Kaiser Permanente: 0.5
Prior authorization denial rates (2022)
CVS Health: 13%
Kaiser Permanente: 10.4%
Centene 9.5%
UnitedHealthcare: 8.7%
Humana: 6.8%
Other BCBS plans: 6.3%
BCBS Anthem: 6.2%
Cigna: 5.8%
A other plans: 5.6%
Elevance Health (Anthem) 4.2%
Read the full report here.
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