In September 2026, Reuters reported that CVS Health’s Aetna in the USA would introduce a single medical prior-authorisation process for cancer treatment, replacing separate approvals for components such as chemotherapy, radiotherapy, imaging and some immunotherapies. The change began on 1 September for Medicaid members in eight US states and is scheduled to reach Aetna’s private and Medicare Advantage plans during the first half of 2027.
Aetna says that providers currently submit an average of four prior-authorisation requests during the course of treatment for each member with cancer. Under the new approach, the provider will submit documentation confirming that the patient is receiving cancer treatment and obtain an approval covering the relevant pathway at an earlier stage. Requests will be handled through a single online portal.
Reducing friction in a high-stakes care pathway
Prior authorisation is intended to confirm medical necessity and control inappropriate spending. In practice, repeated requests can generate delays, duplicated documentation and uncertainty for clinicians and patients. These problems are particularly visible in oncology, where treatment often combines several services and where changes in clinical condition may require rapid adjustments.
A CVS-sponsored survey cited by Reuters found that 74% of providers considered administrative burden a major challenge, while 31% identified prior authorisation as its largest component. Cancer was selected for the new process partly because treatment relies heavily on repeated radiology scans that may each trigger an approval requirement. Aetna has indicated that it may later extend the model to musculoskeletal conditions.
The reform therefore does more than digitise the existing process. It changes the unit of authorisation from an individual service to a care pathway. If implemented well, this could reduce interruptions without removing the insurer’s ability to review whether the overall course of treatment meets its clinical policies.
A broader industry shift
Aetna’s initiative forms part of a wider US effort to simplify prior authorisation. In 2025, health insurers represented by AHIP committed to reducing the number of services requiring approval, standardising electronic submissions and accelerating decisions. UnitedHealthcare has announced plans to eliminate about 30% of its prior-authorisation requirements, while Humana has pledged to remove approximately one third of the requirements applying to outpatient services.
Competition is consequently shifting from the number of covered services alone to the way access is administered. An insurer may offer a broad benefit but still create a poor member experience if approval is slow, fragmented or difficult to understand. Conversely, a simpler process can improve trust among plan beneficiaries and providers while reducing avoidable administrative expense.
Important questions remain. The public announcement does not yet provide detailed performance targets, approval rates, exceptions or evidence of clinical outcomes. Employers will need data before concluding that fewer requests produce faster treatment without unintended effects on utilisation or cost.
What multinational employers should measure
For employee-benefits leaders, administrative friction should become an explicit purchasing criterion. Traditional comparisons focus on premium, network size, exclusions and cost sharing. They should also measure how employees move through the system: the number of authorisations per episode, median response time, requests for additional information, appeal rates, treatment delays and abandonment.
These indicators are especially relevant to multinational programmes. Approval practices differ widely by country, insurer and medical system, which makes a global promise difficult to translate into a consistent employee experience. Networks and brokers can add value by defining common service standards while recognising local regulatory and clinical constraints.
The Aetna initiative offers a useful design principle: organise administration around the employee’s care journey rather than the insurer’s internal product structure. For complex conditions, one coordinated pathway may be more valuable than several individually efficient but disconnected processes.
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