GITNUXREPORT 2025

Prior Authorization Statistics

Prior authorization causes delays, frustrations, increased costs, and hampers care quality.

Jannik Linder

Co-Founder of Gitnux, specialized in content and tech since 2016.

First published: April 29, 2025

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Statistic 1

Nearly 80% of physicians find prior authorization most burdensome

Statistic 2

The average time taken to secure prior authorization is approximately 12.4 minutes per claim

Statistic 3

60% of providers spend over 10 hours weekly on prior authorization paperwork

Statistic 4

70% of physicians consider prior authorization a major administrative burden

Statistic 5

72% of providers report that prior authorization leads to delays in prescribing medications

Statistic 6

68% of insurers have tightened prior authorization criteria in recent years

Statistic 7

Patients wait an average of 7.6 days for approval of urgent care prior authorization

Statistic 8

The healthcare industry spends an estimated $23.6 billion annually on prior authorization processes

Statistic 9

48% of healthcare providers report that prior authorization requirements cause them to lengthen patient visits

Statistic 10

82% of healthcare administrators say prior authorization contributes significantly to administrative costs

Statistic 11

The average number of medications requiring prior authorization per provider is over 50 annually

Statistic 12

40% of health plans have pilot programs to eliminate or reduce prior authorization requirements

Statistic 13

75% of physicians report that prior authorization negatively impacts their workflow efficiency

Statistic 14

58% of providers have experienced near-miss errors due to interruptions caused by prior authorization processes

Statistic 15

64% of healthcare professionals cite insufficient staff as a barrier to managing prior authorization efficiently

Statistic 16

52% of healthcare entities have reported increases in patient wait times due to prior authorization

Statistic 17

70% of clinicians say that prior authorization requires more administrative staff, contributing to higher operational costs

Statistic 18

77% of health plans reported they use electronic prior authorization tools, but only 39% of providers utilize them effectively

Statistic 19

65% of pharmacies spend over 3 hours weekly on prior authorization tasks

Statistic 20

45% of Medicaid plans have implemented real-time prior authorization systems, increasing access speed

Statistic 21

70% of healthcare executives agree that reducing prior authorization time could lead to cost savings

Statistic 22

44% of providers have reduced their service offerings to cope with prior authorization burdens

Statistic 23

62% of patients report feeling frustrated with the time required for prior authorization approval

Statistic 24

45% of healthcare offices utilize automated workflows for prior authorization, predominantly for specific high-volume medications

Statistic 25

77% of physicians experience increased burnout due to prior authorization demands

Statistic 26

66% of health systems direct necessary staff to handle prior authorization, impacting other operational areas

Statistic 27

74% of insurers are developing or refining electronic prior authorization systems to improve efficiency

Statistic 28

59% of healthcare providers report that prior authorization negatively affects their revenue cycle management

Statistic 29

50% of health insurance policies require prior authorization for at least 20 different medication classes

Statistic 30

55% of providers say that prior authorization processes are inconsistent across payers, causing delays and confusion

Statistic 31

54% of clinicians report that prior authorization interrupts the clinical decision process

Statistic 32

55% of providers have switched to less effective medications due to prior authorization hurdles

Statistic 33

91% of insurers claim to improve care quality with prior authorization, but only 29% of providers agree

Statistic 34

83% of physicians agree that the process should be standardized across payers

Statistic 35

88% of clinicians support policy reforms to simplify prior authorization processes

Statistic 36

54% of providers indicate that prior authorization policies are more restrictive than clinical guidelines

Statistic 37

83% of payers believe that prior authorization ensures appropriate medication use, but only 38% of providers agree

Statistic 38

69% of physicians believe that prior authorization hampers timely initiation of therapy

Statistic 39

80% of patients report frustration over delays caused by prior authorization

Statistic 40

91% of healthcare providers reported that prior authorization delays patient care

Statistic 41

35% of medical decisions are delayed or affected due to prior authorization issues

Statistic 42

Over 85% of patients experience treatment delays because of prior authorization requirements

Statistic 43

76% of healthcare professionals say prior authorization negatively affects patient satisfaction

Statistic 44

65% of physicians believe prior authorization compromises patient care quality

Statistic 45

67% of patients experience medication non-adherence due to prior authorization delays

Statistic 46

90% of providers think that streamlining prior authorization could improve patient outcomes

Statistic 47

42% of healthcare providers have postponed necessary treatments because of prior authorization delays

Statistic 48

84% of patients find the prior authorization process confusing, leading to non-compliance or treatment refusal

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Key Highlights

91% of healthcare providers reported that prior authorization delays patient care
Nearly 80% of physicians find prior authorization most burdensome
35% of medical decisions are delayed or affected due to prior authorization issues
Over 85% of patients experience treatment delays because of prior authorization requirements
The average time taken to secure prior authorization is approximately 12.4 minutes per claim
60% of providers spend over 10 hours weekly on prior authorization paperwork
70% of physicians consider prior authorization a major administrative burden
76% of healthcare professionals say prior authorization negatively affects patient satisfaction
72% of providers report that prior authorization leads to delays in prescribing medications
68% of insurers have tightened prior authorization criteria in recent years
Patients wait an average of 7.6 days for approval of urgent care prior authorization
65% of physicians believe prior authorization compromises patient care quality
54% of clinicians report that prior authorization interrupts the clinical decision process

Did you know that over 85% of patients experience treatment delays due to prior authorization, while healthcare providers spend more than 10 hours weekly on paperwork—and yet, nearly a third of insurers claim it improves care quality?

Administrative Burden and Efficiency

Nearly 80% of physicians find prior authorization most burdensome
The average time taken to secure prior authorization is approximately 12.4 minutes per claim
60% of providers spend over 10 hours weekly on prior authorization paperwork
70% of physicians consider prior authorization a major administrative burden
72% of providers report that prior authorization leads to delays in prescribing medications
68% of insurers have tightened prior authorization criteria in recent years
Patients wait an average of 7.6 days for approval of urgent care prior authorization
The healthcare industry spends an estimated $23.6 billion annually on prior authorization processes
48% of healthcare providers report that prior authorization requirements cause them to lengthen patient visits
82% of healthcare administrators say prior authorization contributes significantly to administrative costs
The average number of medications requiring prior authorization per provider is over 50 annually
40% of health plans have pilot programs to eliminate or reduce prior authorization requirements
75% of physicians report that prior authorization negatively impacts their workflow efficiency
58% of providers have experienced near-miss errors due to interruptions caused by prior authorization processes
64% of healthcare professionals cite insufficient staff as a barrier to managing prior authorization efficiently
52% of healthcare entities have reported increases in patient wait times due to prior authorization
70% of clinicians say that prior authorization requires more administrative staff, contributing to higher operational costs
77% of health plans reported they use electronic prior authorization tools, but only 39% of providers utilize them effectively
65% of pharmacies spend over 3 hours weekly on prior authorization tasks
45% of Medicaid plans have implemented real-time prior authorization systems, increasing access speed
70% of healthcare executives agree that reducing prior authorization time could lead to cost savings
44% of providers have reduced their service offerings to cope with prior authorization burdens
62% of patients report feeling frustrated with the time required for prior authorization approval
45% of healthcare offices utilize automated workflows for prior authorization, predominantly for specific high-volume medications
77% of physicians experience increased burnout due to prior authorization demands
66% of health systems direct necessary staff to handle prior authorization, impacting other operational areas
74% of insurers are developing or refining electronic prior authorization systems to improve efficiency
59% of healthcare providers report that prior authorization negatively affects their revenue cycle management
50% of health insurance policies require prior authorization for at least 20 different medication classes
55% of providers say that prior authorization processes are inconsistent across payers, causing delays and confusion

Administrative Burden and Efficiency Interpretation

With nearly 80% of physicians burdened by prior authorization—a process costing $23.6 billion annually, prolonging patient waits, fueling burnout, and transforming efficient care into a bureaucratic maze—it's clear that cutting red tape could be the most cost-effective medicine the healthcare industry needs.

Healthcare Provider Practices and Perceptions

54% of clinicians report that prior authorization interrupts the clinical decision process
55% of providers have switched to less effective medications due to prior authorization hurdles
91% of insurers claim to improve care quality with prior authorization, but only 29% of providers agree
83% of physicians agree that the process should be standardized across payers
88% of clinicians support policy reforms to simplify prior authorization processes
54% of providers indicate that prior authorization policies are more restrictive than clinical guidelines
83% of payers believe that prior authorization ensures appropriate medication use, but only 38% of providers agree
69% of physicians believe that prior authorization hampers timely initiation of therapy

Healthcare Provider Practices and Perceptions Interpretation

While payers claim prior authorization improves care, the overwhelming clinician consensus reveals it often breeds delays, compromises medication effectiveness, and calls for standardization—a clinical silver bullet still elusive amid bureaucratic storms.

Patient Experience and Satisfaction

80% of patients report frustration over delays caused by prior authorization

Patient Experience and Satisfaction Interpretation

With 80% of patients feeling frustrated over prior authorization delays, it's clear that bureaucratic bottlenecks are pharmaceutical traffic jams blocking timely access to care.

Prior Authorization Impact on Patient Care

91% of healthcare providers reported that prior authorization delays patient care
35% of medical decisions are delayed or affected due to prior authorization issues
Over 85% of patients experience treatment delays because of prior authorization requirements
76% of healthcare professionals say prior authorization negatively affects patient satisfaction
65% of physicians believe prior authorization compromises patient care quality
67% of patients experience medication non-adherence due to prior authorization delays
90% of providers think that streamlining prior authorization could improve patient outcomes
42% of healthcare providers have postponed necessary treatments because of prior authorization delays
84% of patients find the prior authorization process confusing, leading to non-compliance or treatment refusal

Prior Authorization Impact on Patient Care Interpretation

With nearly all healthcare providers and patients feeling the ripple effects—delays, confusion, and compromised care—it's clear that prior authorization, while intended to streamline medicine, often acts more as a barrier than a bridge to quality treatment.