UnitedHealthcare, the nation’s largest health insurance company, said it will exempt rural physicians and hospitals from “prior authorization requirements across all lines of business.”
The move comes almost a year after the nation’s health insurance companies vowed to “streamline, simplify and reduce” prior authorization, the controversial process of insurers reviewing hospital admissions and medications.
Last summer, the biggest names in health insurance, including Cigna, CVS Health’s Aetna, UnitedHealth Group’s UnitedHealthcare and Humana, were among more than 50 health insurers committing to reducing prior authorization along with simplifying business practices in general. Those sweeping commitments were announced by America’s Health Insurance Plans, also known as AHIP, and the Blue Cross Blue Shield Association. These groups and their health plan members, which provide health benefits to more than 250 million Americans, said they “aim to accelerate decision timelines, increase transparency and expand access to affordable, quality care.” And many have done so, announcing an array of initiatives in recent months to eliminate or reduce the need for patients to seek prior authorization.
On Monday, UnitedHealthcare said it will do three major things for rural healthcare providers that should help them financially while at the same time simplifying the delivery of healthcare across the country.
UnitedHealthcare said it will speed “payments by up to 50%” for 1,500 rural hospitals and all critical Access Hospitals; except rural providers from most medical prior authorization requirements across all lines of business; and launch “new hub-and-spoke partnerships designed to deliver essential services directly to patients in their communities.” By this fall, rural medical care providers will no longer have “most of the medical prior authorization requirements that exist today,” a UnitedHealthcare spokesman said.
“Rural care providers are essential to their communities yet fragile, so we welcome the chance to make meaningful investments to support their work — and we expect to continue investing more and actively building on these initiatives,” said UnitedHealthcare Chief Executive Officer Tim Noel.
The National Rural Health Association, which represents hundreds of rural hospitals, said the move should help providers of medical care in rural America.
“We appreciate UnitedHealthcare’s efforts to ease the financial and administrative strain being felt by rural health care providers,” said Alan Morgan, chief executive officer at the National Rural Health Association. “We look forward to working with UnitedHealthcare to ensure local providers in rural areas have the support they need to care for the people in their communities.”
Hospital closures in rural American are on the rise and are expected to escalate in the coming years in part due to major cuts in reimbursement passed into law by Congress. The One Big Beautiful Bill Act that Donald Trump signed into law last year is projected to reduce federal spending on Medicaid insurance for poor Americans by about $1 trillion over a decade.
UnitedHealthcare said its initiatives announced Monday should help “independent rural hospitals improve cash flow and enhance financial stability, ensuring continued access to quality care for local residents.”
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