Thoughts on prior authorization, healthcare technology, and building a better system.
Week four snapshot after the CMS-0057-F deadline. Metrics compliance hasn't moved across 1,304 payers. But our FHIR sweep found something new: PACE North (H4256) is now exposing a full Da Vinci PAS endpoint — the first 3/3 FHIR score in our survey.
CMS finalized the biggest PA rule in a decade, launched a Medicare AI denial pilot in January, and is now being sued over the contract. Three regulatory regimes are pulling in three directions at once.
Week three snapshot after the CMS-0057-F deadline: compliance across 1,304 payers remains stuck at 9%. Three full weeks, and 1,185 payers still show zero evidence of publishing required prior authorization metrics.
Week two update after the March 31, 2026 CMS-0057-F deadline: we expanded the survey to all 1,304 impacted payers. 1,185 have published nothing. Compliance dropped from 13% to 9% as coverage widened.
New survey data from the AHA shows that prior authorization has surpassed cost as the number one barrier to healthcare access in America. This is the logical conclusion of everything broken about the system.
Nearly half of American physicians are considering leaving medicine — and prior authorization is the number one driver of burnout in 2026. The workforce crisis is here.
The average medical practice spends over $70,000 per year on prior authorization — and that's before you account for dedicated staff. Here's the real cost breakdown, and why the CMS 2026 FHIR mandate makes it worse before it gets better.
84% of insurers now use AI for prior authorization decisions, and denial rates are 16x higher when they do. Physicians, lawmakers, and researchers are sounding the alarm.
Physicians spend 13 hours per week on prior authorization paperwork — nearly two full days lost to bureaucracy instead of patient care. The AMA data is damning, and the U.S. Senate is finally paying attention.
Five days after the federal deadline, we surveyed 1,296 payers for prior authorization transparency compliance. The results paint a damning picture.
How the United States built a $23 billion administrative apparatus to second-guess every medical decision — and why it will take more than technology to tear it down. A deep dive into the history and future of prior authorization.
Week one after the March 31, 2026 CMS-0057-F deadline: we surveyed 188 payers. Only 25 showed any evidence of publishing their required prior authorization metrics. The first snapshot of a national compliance failure.
New research shows that heart failure patients waiting on prior authorization take 3x longer to fill ARNIs and 6x longer for SGLT2 inhibitors — guideline-recommended therapies that reduce mortality.
New transparency data shows that 4 out of 5 prior auth denials are reversed when appealed. The initial denial isn't a medical decision — it's a bet that you won't fight back.
A Johns Hopkins study found that every oncologist surveyed reported patient harm from prior authorization. 80% watched cancer progress while waiting. 36% lost a patient.
Prior authorization was designed to control costs. Instead, it's become the single biggest administrative burden in healthcare. Here's why, and how Artificer Health is fixing it.