Aetna Survey Highlights Strong Payer-Provider Trust and Growing Support for AI to Reduce Healthcare Costs
Aetna, a CVS Health company, has released findings from its third-quarter 2026 Provider Survey, highlighting continued stability in payer-provider trust, progress in simplifying prior authorization processes, and growing recognition of technology as a tool to reduce administrative burdens and combat healthcare fraud, waste, and abuse.
The quarterly survey examines how healthcare providers across the United States view health insurers, the broader healthcare industry, and the challenges likely to shape care delivery in the coming years. By collecting feedback from physicians, nurses, hospital system executives, pharmacists, and healthcare technology leaders, Aetna aims to identify opportunities to strengthen relationships between healthcare payers and providers, improve transparency, and support more affordable and accessible care.
The latest findings suggest that payer-provider relationships have maintained the improvements recorded earlier in 2026. While administrative challenges remain a concern for healthcare professionals, the survey indicates that providers are increasingly optimistic about efforts to streamline authorization procedures. At the same time, respondents identified access to real-time patient information and the use of artificial intelligence (AI) to detect suspicious claims as important opportunities to improve efficiency and control healthcare spending.
Payer-Provider Trust Remains Stable in the Third Quarter
According to the Q3 2026 survey, the average trust score between healthcare payers and providers reached 6.0 on a 10-point scale. This result was broadly consistent with the 6.1 score recorded in the second quarter, indicating that the gains achieved earlier in the year have largely been sustained.
The second-quarter score represented a notable improvement over the 5.4 recorded in the first quarter. The latest results suggest that relationships between payers and providers continue to benefit from improvements in communication, transparency, and attention to patient needs.
Several survey findings illustrate how providers perceive payer performance. Half of the respondents said healthcare payers make decisions that prioritize patient well-being. This represented an increase of two percentage points compared with the second quarter and six percentage points compared with the first quarter.
Additionally, 52% of providers said payers consistently fulfill their promises, while 56% reported that payers provide clear and understandable information. Both figures remained unchanged from the previous quarter, suggesting that these aspects of payer performance have remained relatively stable.
Although the results indicate continued progress, they also highlight opportunities for health insurers to strengthen their relationships with clinical organizations. Trust is an important component of effective healthcare collaboration because providers and payers must work together on coverage decisions, patient access, care coordination, and the responsible use of healthcare resources.
Steve Nelson, Executive Vice President of CVS Health and President of Aetna, emphasized the importance of maintaining strong relationships with healthcare providers.
He said the continued strength of payer-provider trust scores was encouraging and noted that closer provider partnerships could help improve access to affordable care while making the healthcare system easier for members to navigate. Nelson also acknowledged that additional work remains to be done, while expressing optimism that providers are recognizing Aetna’s investments in reducing administrative friction and improving transparency.
For healthcare organizations, stronger payer-provider relationships can help support more predictable processes, clearer communication, and better coordination around patient care. The survey’s findings suggest that maintaining this progress will require continued attention to the operational challenges experienced by clinical teams.
Prior Authorization Improvements Help Reduce Administrative Burden
Administrative work continues to place significant pressure on healthcare providers, particularly clinical staff who must balance patient care with documentation, insurance requirements, and other operational responsibilities. However, the third-quarter survey indicates that providers are beginning to see progress in efforts to address these challenges.
In Q3 2026, 67% of providers identified administrative burden as one of their leading challenges. This was seven percentage points lower than the figure reported in the second quarter, indicating a reduction in the proportion of respondents highlighting the issue as a top concern.
The findings also revealed a change in how providers view their future challenges. Administrative burden was no longer ranked as the leading anticipated challenge over the next five years. Instead, providers identified the amount of time they can spend with each patient as their most significant expected concern.
This shift highlights the importance of improving administrative efficiency while protecting the time healthcare professionals need to deliver quality care. As healthcare organizations face increasing demands on their resources, reducing paperwork and simplifying routine processes could help clinical teams focus more attention on patient needs.
Prior Authorization Remains a Key Area for Improvement
Prior authorization has long been a source of administrative work for providers, requiring healthcare professionals and their teams to obtain approval from health insurers before delivering certain treatments, procedures, or medications.
The Aetna survey suggests that efforts to simplify prior authorization are beginning to influence provider perceptions.
Among respondents who identified administrative burden as a major challenge, 27% named prior authorization as its leading contributor. This was down from 31% in the second quarter, representing a four-percentage-point decline.
Providers also expressed greater confidence in payer initiatives designed to streamline authorization processes. Among respondents who expected payers to simplify prior authorization, more than 50% attributed their confidence to automation and industry-wide commitments to accelerate turnaround times. In the second quarter, approximately 40% cited these factors.
These results suggest that providers increasingly view technology and coordinated industry action as potential solutions to delays and unnecessary administrative work.
Automation can help reduce repetitive tasks, improve the consistency of information submitted for review, and support faster processing of authorization requests. However, the effectiveness of these approaches depends on how well systems are implemented and whether they address the practical needs of healthcare providers.
For payers and providers, continued collaboration will be important to ensure that administrative improvements translate into more efficient workflows and fewer disruptions to patient care.
Real-Time Patient Information Could Further Improve Healthcare Efficiency
Although the survey indicates progress in reducing administrative burden, access to timely and accurate patient information remains a major challenge.
Updating patient medical records was identified as the single largest contributor to administrative burden among providers who named the issue as a leading concern. Approximately 58% of these respondents cited medical record updates, an increase of five percentage points compared with the second quarter.
The finding highlights the difficulties healthcare professionals can face when patient information is incomplete, outdated, or distributed across disconnected systems.
When providers cannot readily access the information they need, clinical teams may spend additional time gathering records, verifying details, and updating documentation. These processes can add to administrative workloads and complicate coordination between healthcare organizations.
The survey identified real-time patient information as a leading opportunity for payers to help address these problems. Nearly one in three providers said that making patient information available in real time was the most important action payers could take to address current challenges.
Improving access to relevant information could help providers make better-informed decisions, reduce repetitive administrative tasks, and coordinate care more effectively. It could also help healthcare organizations identify gaps in patient records before those gaps create delays in treatment or other operational complications.
Interoperability is another important component of this opportunity. Healthcare systems need to exchange information securely and efficiently so that authorized professionals can access relevant records when needed.
Among providers who expressed confidence in technology, 25% said interoperability was improving member outcomes. This represented a seven-percentage-point increase from the second quarter.
The results indicate that providers are increasingly recognizing the potential value of connected healthcare technology. Nevertheless, continued progress will depend on reliable information exchange, effective system integration, and the ability of healthcare organizations to incorporate digital tools into their existing workflows.
Healthcare Fraud, Waste and Abuse Remain Major Industry Concerns
Beyond administrative efficiency, the survey examined provider perspectives on fraud, waste, and abuse across the healthcare system.
The findings showed broad agreement that these issues require attention. Approximately 94% of surveyed providers agreed that fraud, waste, and abuse represent problems the healthcare system needs to address.
These concerns extend beyond individual insurance claims. Improper payments, suspicious billing patterns, unnecessary services, and other forms of misuse can contribute to rising healthcare expenditures and place additional pressure on a system already working to manage costs.
When respondents were asked about the principal benefit of addressing fraud, waste, and abuse, nearly 60% identified lowering overall healthcare costs as the most important outcome.
The results suggest that providers view stronger fraud prevention as a potential way to improve the financial sustainability of healthcare delivery while supporting more responsible use of available resources.
Respondents also estimated the financial scale of the problem. A majority, or 57%, believed that fraud, waste, and abuse cost the healthcare system approximately $100 billion to $499 billion annually. This figure reflects the estimates reported by survey participants rather than an independently verified measurement of total annual losses.
Reducing improper payments and identifying potentially fraudulent activity could help healthcare organizations and insurers direct resources toward legitimate medical services and patient needs.
The survey findings also point to the importance of collaboration between payers and providers in addressing these challenges. Better information sharing, improved claims analysis, and more effective identification of unusual billing patterns could support efforts to detect potential problems earlier.
Providers See Artificial Intelligence as a Tool to Detect Suspicious Claims
Artificial intelligence emerged as a leading recommendation from providers seeking more effective ways to address healthcare fraud, waste, and abuse.
Approximately 30% of respondents said payers should use AI to flag suspicious claims or identify unusual patterns. This was the most frequently recommended action for addressing the issue.
AI-based systems can analyze large volumes of claims data and identify patterns that may warrant further investigation. For example, these tools can help highlight unusual billing activity, repeated claim submissions, or patterns that differ from expected behavior.
Such capabilities could allow insurers to prioritize cases requiring closer review and help investigators focus their attention on potentially problematic transactions.
However, identifying an unusual pattern does not automatically establish that fraud has occurred. Claims may differ for legitimate clinical or operational reasons, making human review and appropriate verification important parts of the process.
The survey also found substantial provider confidence in the potential impact of these technologies. Nearly nine in 10 respondents believed that payers could realistically reduce up to half of fraud, waste, and abuse each year.
Approximately 90% of providers also believed AI was already helping to address the problem.
These responses indicate that providers see artificial intelligence as a promising component of broader fraud prevention strategies. At the same time, the findings reflect provider perceptions and expectations rather than proof that AI has already achieved the estimated reductions across the healthcare system.
For healthcare payers, the challenge will be to apply AI responsibly, maintain appropriate oversight, and ensure that fraud detection processes distinguish legitimate claims from potentially improper activity. Effective implementation could help strengthen payment integrity while minimizing unnecessary delays for providers and patients.
Technology and Collaboration Could Shape the Future of Payer-Provider Relationships
Taken together, the third-quarter findings highlight several connected priorities for the healthcare industry: sustaining trust between payers and providers, simplifying prior authorization, improving access to patient information, and strengthening efforts to reduce fraud, waste, and abuse.
These priorities are closely linked. Administrative processes that are easier to navigate can reduce the workload placed on clinical teams. Better access to information can support more coordinated care, while technology-enabled fraud detection can help insurers identify suspicious activity and protect healthcare resources.
For Aetna, the findings provide feedback on areas where continued investment and collaboration may help improve relationships with providers.
The survey also underscores the importance of measuring progress over time. Quarterly feedback allows healthcare organizations to track changes in provider perceptions, identify persistent problems, and evaluate where additional improvements may be needed.
Although the latest results indicate that trust has remained relatively strong compared with earlier periods in 2026, the survey also demonstrates that important challenges remain. Healthcare providers continue to seek more efficient administrative processes, timely access to patient information, and practical solutions that allow them to devote more time to patient care.
As digital technologies continue to develop, healthcare payers and providers will need to focus on solutions that address these operational needs while maintaining transparency, accountability, and appropriate safeguards.
Survey Methodology and About the Aetna Provider Survey
The national study was conducted during the third quarter of 2026 by Morning Consult, a global decision intelligence company. The survey included a representative sample of 727 healthcare providers and industry participants from across the United States.
Participants included hospital system executives, physicians, nurses, pharmacists, and healthcare information technology leaders, including chief technology officers and chief information officers.
The overall margin of error was reported as plus or minus four percentage points.
The Aetna Provider Survey is a quarterly research initiative designed to understand how healthcare providers perceive payers, the healthcare industry, and the challenges and opportunities expected to influence the sector in the future.
By gathering timely feedback from a representative sample of the U.S. provider market, the survey aims to identify opportunities to improve payer-provider relationships, strengthen trust, and support changes that could benefit healthcare professionals and the people they serve.
The Q3 2026 findings indicate that payer-provider trust has remained stable following improvements earlier in the year. They also highlight growing provider confidence in efforts to simplify prior authorization, improve information exchange, and apply artificial intelligence to identify suspicious claims.
As the healthcare industry continues to address cost pressures and administrative complexity, these findings reinforce the importance of collaboration, transparency, and technology-enabled solutions in building a more efficient healthcare system.
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