UnitedHealthcare eliminates prior authorization for rural providers

UnitedHealthcare is scrapping prior authorization requirements for rural healthcare providers in a move that will help lower costs and streamline processes, the company said in a press release.

UnitedHealthcare will also speed up payments for around half of all rural hospitals and critical access hospitals, as well as develop a new partnership to deliver healthcare services directly within rural communities.

These changes come as the industry faces a mounting rural health problem.

Rural healthcare organizations face staffing shortages and tight margins, creating a perfect storm to limit patient access to care. In February 2025, a report from The Chartis Center for Rural Health found that nearly half of U.S. rural hospitals are in the red due to reduced reimbursements and dwindling healthcare access and utilization.

According to Tim Noel, CEO for UnitedHealthcare, these changes will better support rural health systems.

"Rural care providers are essential to their communities yet fragile, so we welcome the chance to make meaningful investments to support their work -- and we expect to continue investing more and actively building on these initiatives," Noel said in a statement.

The cornerstone of the new UnitedHealthcare policies is the change in prior authorization requirements for rural health facilities. The payer said that by the fall of 2026, it will have eliminated prior authorization requirements for around 1,500 rural hospitals, including critical access hospitals. The program will also expand to include Medicaid and commercial plan payments.

The move should reduce administrative burden and costs for rural health systems, UnitedHealthcare said.

Additionally, the payer said it has expanded its Rural Payment Acceleration Pilot by five states -- Alabama, Arkansas, Kentucky, Virginia and West Virginia. The pilot originated in four states and sped up Medicare Advantage payments from 30 days to 15 days, UnitedHealthcare said.

Finally, UnitedHealthcare said it's launching a "hub-and-spoke" model for rural healthcare that aims to connect regional healthcare experts to community-based clinics. The payer said it plans to leverage mobile and virtual care, data interoperability, health data analytics, clinical decision support and home-based care as a part of this model.

The program will start with a focus on maternal healthcare, diabetes and post-surgical care, with the intention of building a model for additional markets.

The program has received initial support from rural healthcare leaders. According to Alan Morgan, the CEO of the National Rural Health Association, the news from UnitedHealthcare will help drive down administrative burden.

"We appreciate UnitedHealthcare's efforts to ease the financial and administrative strain being felt by rural health care providers," Morgan said in the UnitedHealthcare press release. "We look forward to working with UnitedHealthcare to ensure local providers in rural areas have the support they need to care for the people in their communities."

Sara Heath has reported news related to patient engagement and health equity since 2015.