Cohere Health and Innovaccer Leading the Way in Prior Authorization Transformation
NEW YORK CITY, NY – July 26, 2025 – As U.S. healthcare undergoes a significant transformation, Black Book Research has spotlighted Cohere Health, Innovaccer, and Waystar among those rapidly adapting to new industry regulations. Major insurers like UnitedHealthcare and Humana are set to reduce or eliminate prior authorization (PA) requirements for numerous routine procedures, prompted by federal mandates and consumer calls for quicker access to care.
A July 2025 flash survey revealed that insurers, covering over 250 million Americans, aim to streamline PA processes by the close of 2026. This drive is reinforced by the Centers for Medicare & Medicaid Services (CMS), launching a pilot program in January 2026 for faster, more transparent PA for select Medicare services.
Key insights from the survey indicate overwhelming support for reducing PA burdens, with 84% of managed care executives in favor. Impressively, 99% of consumers agree that eliminating PA for routine care is essential, with a staggering 83% reporting harmful delays due to the current system.
Leading vendors have emerged as pivotal players in this shift. Cohere Health excels in AI-based automation and interoperability, while Innovaccer stands out with robust EHR integration and compliance tools. Waystar is enhancing its platform for real-time eligibility verification.
However, not all vendors are adapting, with some reliant on outdated systems facing existential threats. The dynamic landscape suggests a bright future for companies investing in automated and integrated PA solutions. Doug Brown, founder of Black Book Research, stated, “The future of prior authorization is transparent, automated, and fully integrated into clinical workflows.”
As the industry evolves, vendors providing real-time, AI-driven solutions will define a new era of healthcare efficiency for all stakeholders involved. For further information, visit Black Book Research.
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