Aetna Provider Survey Shows Payer-Provider Trust Remains Strong; Providers say Reducing Fraud can Significantly Lower Health Care Costs

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Aetna Provider Survey Shows Payer-Provider Trust Remains Strong; Providers say Reducing Fraud can Significantly Lower Health Care Costs

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  • 6.0 trust score consistent with significant improvement reported in Q2
  • Fewer providers single out prior authorization as the main driver of administrative burden, and they reveal their next recommended focus area
  • Respondents believe that addressing fraud, waste and abuse can reduce the cost of care

HARTFORD, Conn., Oct. 26, 2026 /PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS), today announced findings from the Q3 Aetna Provider Survey. The Aetna Provider Survey is a quarterly study that polls the U.S. provider market to better understand their perceptions on payers and the industry, today and into the future. This survey series is intended to solicit timely, objective feedback from the U.S. provider market so we can identify opportunities to change the payer-provider dynamic and deepen trust over time.

Image provided by Aetna, a CVS Health company.

The study revealed that the average payer-provider trust score in Q3 was 6.0 on a scale from 1 to 10, in line with the 6.1 score reported in Q2. The Q2 score was a significant increase from 5.4 in Q1, suggesting that in Q3 payers sustained improvements with providers in several areas:

  • 50% of providers said payers make decisions that prioritize patient well-being, an increase of two percentage points from Q2 and six percentage points from Q1.
  • 52% of providers said payers consistently deliver on their promises and 56% said payers provide clear, understandable information, both unchanged from Q2.

"Building trust remains our priority, and I am pleased to see the payer-provider trust scores remain strong. Deepening our provider relationships helps us partner closely to improve access to affordable care and makes it easier for members to navigate the health care system," said Steve Nelson, Executive Vice President of CVS Health and President of Aetna. "We have more work ahead of us but I am encouraged to see providers are recognizing Aetna's investments to reduce friction and improve transparency."

Payers make clear progress on prior authorization; real-time patient information is the next opportunity to lower administrative burden

Administrative burden remains a significant - but improving - challenge for clinical staff. Fewer providers (67%) identified administrative burden as their top challenge today, declining seven percentage points from Q2. Providers also no longer rank it as their leading anticipated challenge five years from now, with time with each patient now ranking highest.

Providers expressed confidence in payer efforts to simplify prior authorization, helping to spark the change.

  • Among providers who cited administrative burden as a top challenge, 27% named prior authorization as the leading contributor, down from 31% in Q2.
  • Among providers who expect payers to simplify prior authorization, over 50% cited automation and industry-wide commitments to accelerate turnaround times as the reason for their growing confidence, up from about 40% in Q2. 

Providing real-time patient information to providers is the next opportunity to further address key challenges, such as easing administrative burden and improving patient care. 

  • Updating patient medical records remains the single biggest contributor to administrative burden, named by 58% of providers who cited administrative burden as a top challenge and up five percentage points from Q2.
  • When asked the most important action payers could take to address their current challenges, nearly 1 in 3 providers said providing real-time patient information – the top answer.

Beyond reducing administrative challenges, among providers confident in technology, 25% now credit interoperability with improving member outcomes, an increase of seven percentage points from Q2.

The top benefit of addressing fraud, waste and abuse is lowering the cost of health care

Nearly all providers (94%) agreed that fraud, waste and abuse is a problem the health care system needs to address. Close to 60% said the top benefit was lowering overall costs in the health care system; most (57%) estimated that fraud, waste and abuse cost the system about $100B to $499B annually.

When asked the most important action payers could take to address the issue, providers saw a key role for AI.

  • About 30% of providers said they want payers to use AI to flag suspicious claims or patterns – their top recommended action.
  • Nearly 9 in 10 providers believe payers can realistically reduce up to half of fraud, waste and abuse each year.

About 90% of providers also believe that AI is already helping to solve the issue.  

Survey methodology and the Aetna Provider Survey

The national study was conducted in Q3 2026 by Morning Consult, a global decision intelligence company. The survey polled a representative sample of U.S. providers comprised of 727 participants, including hospital system executives, physicians, nurses, pharmacists, and health IT leaders (CTO/CIOs) nationwide. The overall margin of error is ±4 percentage points. 

The Aetna Provider Survey is a quarterly study that polls a representative sample of the U.S. provider market to better understand their perceptions, opportunities, and challenges today and into the future. This survey series is intended to solicit timely, objective feedback from the U.S. provider market so we can identify opportunities to change the payer-provider dynamic and deepen trust over time.

About Aetna

Aetna, a CVS Health business, serves an estimated 37 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care professionals, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com .

About CVS Health

CVS Health is a leading health solutions company simplifying health care one person, one family and one community at a time. As of June 30, 2026, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics and a leading pharmacy benefits manager with approximately 87 million plan members. The Company also serves an estimated 37 million people through a broad range of health insurance products and related services. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.

Media contact

Phil Blando
Phillip.blando@cvshealth.com

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SOURCE CVS Health