Insider explains the true purpose behind prior authorizations in U.S. health insurance

The STAT+ newsletter article by Bob Herman reports on an interview with Archelle Georgiou, who previously worked at the nation’s largest health insurer and was involved in efforts to curb prior authorization requirements.

Georgiou explains that prior authorizations are less about clinical safety and more about controlling costs and managing utilization, describing how the process often results in denied claims as an intended outcome.

The piece highlights ongoing frustration among patients and providers with the system and suggests that the practice persists because it serves financial objectives for insurers rather than improving care quality.