October 26, 2026 · Insurance operations
An October 21 CMS and Labor Department announcement brings self-funded employers into the prior authorization reform effort. What clinics should verify before changing their process.
ONC’s latest analysis points to uneven progress: less substantial after-hours documentation, but a persistent and growing authorization burden.
Three tasks, different trends
In its September 30 update, ONC reported that the share of family physicians experiencing substantial after-hours documentation fell from 41% in 2024 to 34% in 2026. Substantial effort obtaining outside health information also declined. The share reporting substantial prior authorization burden, however, rose from 54% to 58%.
Those measures describe different tasks. Improvement in one does not establish that the rest of a practice’s administrative workload has improved.
What the underlying study can establish
The related peer-reviewed study examined responses from 8,419 family physicians completing certification requirements in 2024. More than three-quarters reported at least one substantial burden, and 15% reported all three. The authors found associations between some documentation supports and lower reported burden, but completing authorization work inside the EHR was not associated with lower authorization burden.
The study is cross-sectional and uses self-reported data from one specialty. It does not show that a particular product caused a reduction, or that every practice will see the same results.
Measure the handoffs, too
For a local pilot, our recommendation is to separate draft creation, clinician review, external-record retrieval and payer follow-up. Count the work that moves to another person as well as the work that disappears. A fast note draft and a growing pile of unresolved coverage questions can coexist.
A useful review asks where the next person finds the information, whether they can trust its source and whether the next action is clear. That keeps an interoperability or ambient-scribe project tied to the clinical team’s day rather than to a single attractive dashboard number.
Sources & reporting notes
- ONC — Less Pajama Time, More Patient Time · 2026-09-30
- Gabriel et al. — The Triple Burden of Administrative Tasks Among US Family Medicine Physicians · 2026-08-04
Reporting checked October 26, 2026. Source facts are linked above; operational recommendations are Fluent’s editorial analysis.
