Insights That Move the Needle.

For the First Time, the Numbers Are Public

For decades, prior authorization operated as one of American healthcare’s most consequential blind spots. Physicians submitted requests, insurers approved or denied them, and almost no one outside those transactions knew the aggregate numbers. How often did plans say no? How long did decisions take? How often did patients appeal and win?^1,3

March 31, 2026 changed that. Under the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), health insurers were required to post prior authorization metrics on their public websites for the first time. Approval rates, denial rates, appeal overturn rates, and processing times are now on the record.¹

What’s emerging from that data is not a minor compliance footnote. It is a structural indictment of how prior authorization has functioned and a signal that CMS intends to redesign the system from the ground up rather than tinker at the margins.^1,5

“CMS is not simply trying to reduce administrative burden. It is defining the operating model through standards, timelines, and data exchange.”²

The healthcare buyer journey has never been simple. But AI is rewriting the map. From intelligent content discovery to predictive procurement signals, the way health system leaders research and evaluate vendors has fundamentally changed. Marketers who still think in linear funnels are already behind.

So how do you ensure your organization is keeping pace?