The Prior Auth Index
The Prior Auth Index tracks prior authorization transparency data, publication status, denial metrics, appeal outcomes, and reporting usability across U.S. health plans.
Reporting context
CMS required impacted health plans to begin publicly reporting prior authorization metrics under CMS-0057-F. The rule created the first large-scale public dataset covering approval rates, denial rates, appeal outcomes, and decision timeframes across portions of the U.S. insurance market.
Publication status alone does not determine whether reporting is usable, comparable, or complete. Reporting formats vary across plans, including structured tables, PDFs, incomplete pages, unavailable links, and disclosures that do not contain the required prior authorization metrics. The Index tracks those differences at the source level.
What the Index tracks
How the data is used
Prior authorization reporting is most useful when source context, reporting format, plan type, metric definitions, and publication quality are reviewed together.
The Index organizes public prior authorization transparency data into a structured reference point for reviewing payer disclosures, reporting gaps, denial and appeal patterns, and workflow-related findings across health plans.
The Index is independent and updated as new public reporting sources are identified.
The Prior Auth Report launches in July.
Ongoing analysis covering payer reporting behavior, prior authorization transparency data, denial and appeal patterns, workflow burden, and CMS compliance trends.
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