April 7, 2026

Insurers Say PA Reforms Taking Hold

The two main insurer trade groups say definitive progress is being made to implement voluntarily agreed-upon prior authorization (PA) reforms. AHIP and the Blue Cross Blue Shield Association released a report that found leading health plans reduced prior authorizations for an array of services by 11% since the pledge was made. This equates to 6.5 million fewer prior auth requests for patients. Reductions in Medicare Advantage were 15%.

The insurers say that PAs were removed where there were clear clinical guidelines and consistent utilization trends for providers. The groups say insurers have introduced more consumer-friendly language and appeals steps.

About 50 plans signed on to the initiative, including all six of the largest, publicly traded plans.

#priorauthorization #healthplans

https://www.fiercehealthcare.com/payers/insurers-have-eliminated-11-prior-authorizations-under-reform-pledge

Wakely’s BALANCEd Assessment

Wakely released a great analysis on what health plans need to consider if they join the BALANCE model, which would bring GLP-1 coverage to Medicare Part D enrollees who have obesity. The drugs are already covered for other disease states, such as heart disease and diabetes.

Wakley made some interesting observations:

Higher risk scores among currently eligible GLP-1 utilizers do not correspond to higher claims costs relative to non-users (they have lower risk scores but higher claim costs).

GLP-1 utilizers have the lowest net claims costs after normalizing using MA risk scores for all GLP-1 eligible populations under BALANCE. But that could change as plan sponsors accept more Part D liability.

Net claims costs for the utilizer cohort are materially lower in inpatient and outpatient spending in all years than for the non-utilizing eligible population but higher in professional and other medical. Wakely says it cannot definitively associate GLP-1 usage to lower inpatient costs.

#glp1s #weightlossdrugs #medicareadvantage #partd #pdp #balance

https://www.wakely.com/wp-content/uploads/2026/04/Understanding-Selection-Risk-Under-BALANCE-FINAL.pdf

— Marc S. Ryan

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