2026 Prior Authorization Burden Report
74 sourced statistics on how much prior authorization there is, how long it takes, how often it is denied and then reversed, and what changes under the CMS 2026 rule. Every number traces to a named primary source.
Prior authorization in 2024 and 2025, by the numbers
Six findings from the report. Each is dated and linked to its primary source inside the full report.
Medicare Advantage prior authorization requests in 2024, and that is one program alone.
Per physician per week on prior authorization, at about 40 requests each week.
Of appealed Medicare Advantage denials were overturned, yet only 11.5% were appealed.
Of denied prior authorization requests actually met Medicare coverage rules.
Of physicians reported a prior-authorization-linked serious adverse event for a patient.
CMS rule requires 72-hour and 7-day decisions; the enabling APIs are due by 2027.
Bottom line: prior authorization is high in volume, heavy in staff time, and often reversed on appeal yet rarely appealed, and the 2026 CMS rule speeds decisions without reducing the work.
- A key-findings dashboard and hand-built charts across 10 chapters
- The Prior Authorization Complexity framework across six workflow dimensions
- A methodology and limitations note, numbered sources, and a machine-readable data appendix
- What each finding means for a practice on Monday morning
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- 74 statistics, every one linked to a primary source
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About the data: every figure in this report is drawn from the named primary source cited alongside it, including KFF, the American Medical Association, the HHS Office of Inspector General, CMS, CAQH, MGMA, and Health Affairs. Staffingly, Inc. compiled and summarized these figures and does not claim ownership of the underlying data. This material is provided for general informational purposes only and is not legal, clinical, financial, or compliance advice.