Progress report: Supporting health plan adoption of AHIP prior authorization commitments
In 2025, more than 50 health plans, including many of our customers, voluntarily joined America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA) in an industry-wide commitment to simplify and modernize prior authorization (PA). For many of those health plans, delivering on these commitments hinges not only on policy decisions that impact their PA programs, but on the operational readiness of their PA partners.
As a medical benefits management partner, we help health plans turn commitments like these into real progress on prior authorization reform as part of broader utilization management modernization.
Keep reading for a snapshot of our progress, what’s already been delivered, and what’s ahead. Bookmark this page and check in on our quarterly progress updates.
Prior authorization progress snapshot
How Carelon is supporting health plan adoption of AHIP commitments
Commitment
Status
Expanding real-time responses
Active today
Ensuring medical review of non-approved requests
Active today
Ensuring continuity of care when patients change plans
Active today
Enhancing communication and transparency on determinations
In progress
Reducing the scope of claims subject to prior authorization
In progress
Standardizing electronic prior authorization
In progress
Last updated: Q2 2026
What AHIP commitments mean for key stakeholders
- For patients: A more timely and connected care experience, supported by clearer and more streamlined prior authorization processes.
- For providers: A more streamlined experience with fewer manual steps, clearer submission requirements, and faster decision-making.
- For health plans: Confidence that prior authorization modernization is underway and that broader utilization management improvement is achievable with connected workflows, clearer standards, scalable digital infrastructure, and the right partner.
- For the industry: Evidence that prior authorization reform is underway and measurable when grounded in real data, clinical expertise, and visibility over time.
Provider experience foundation
Provider experience provides important context for this work. In our 2025 survey of nearly 11,000 providers, overall satisfaction with our services remained high at 91%, continuing more than a decade of 90%+ provider satisfaction. These results reflect the experience providers already have working with us and provide important context as prior authorization modernization continues.
Key findings from our survey include:
- 91% overall provider satisfaction
- 88% reported our portal as easy to use
- 86% rated our prior authorization process as efficient
Contact us for more information about how we support health plans’ AHIP commitments.
Related reading:
Understanding the CMS Interoperability and Prior Authorization Final Rule – How can it help connect care and streamline experiences?