Prior Authorization Metrics

Follow prior authorization metrics as they change.

The Prior Auth Index tracks denial rates, appeal activity, overturned decisions, and reporting patterns across available payer transparency data. Join the report list for updates when new analysis, payer data, and methodology notes are published.

Source: KFF analysis of CMS Medicare Advantage data, January 2026

Data Interpretation

Published denial and approval rates are not direct quality rankings. Reporting methodologies, contract structures, aggregation standards, and partial-denial definitions vary between reporting entities and markets. The Index preserves source context while improving accessibility and comparability across publicly reported datasets. Read the Index methodology.

Reporting Coverage Notice

The comparative metrics shown here are limited to publicly available structured datasets and payer disclosures that can be reasonably normalized for comparison. Many entities tracked in the payer directory have not yet published complete or standardized prior authorization metrics.

Additional payer metrics and comparative reporting will be added as more disclosures become publicly available under CMS prior authorization transparency requirements.

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Published prior authorization denial rates for major Medicare Advantage and ACA Marketplace insurers. Plans are displayed from highest reported denial rate to lowest.