Aetna’s provider trust score inches higher as administrative friction eases
Aetna’s latest quarterly provider survey points to a slow but measurable shift in payer-provider relations. The insurer said the trust score reached 6 out of 10 in the third quarter, essentially flat from 6.1 in the second quarter but up from 5.4 in the first quarter, a gain that suggests some of the sharpest frustrations are beginning to ease. For an industry built on repeated friction over coverage rules, claims review, and payment clarity, even a modest rise carries weight.
Steve Nelson, president of Aetna, framed the effort as a response to a system-wide credibility problem. He said trust is at an all-time low, and the company has been focused on the pressure points most likely to damage it: administrative burden, prior authorization, and transparency around decisions. The message from the survey is not that those concerns have disappeared. It is that some providers now see movement where there was little before.
The third-quarter survey, conducted by Morning Consult, included 727 respondents spanning hospital executives, physicians, nurses, pharmacists, and health tech leaders across the country. Half of those surveyed said insurers make decisions that support patient well-being, up from 48% in the second quarter and 44% in the first quarter. Fifty-two percent said payers deliver on their promises consistently, while 56% said payers provide clear and understandable data, both unchanged from the prior quarter.
Those numbers matter because payer relationships are often judged less by mission statements than by the daily mechanics of care delivery. Prior authorization, claim denials, opaque policy changes, and delayed determinations can quickly become clinical bottlenecks. When the administrative path gets simpler, the effect reaches beyond billing departments and into exam rooms, infusion suites, and discharge planning workflows.
Administrative burden still sits at the center of the complaint list. Sixty-seven percent of providers named administrative hurdles as their biggest challenge, down six percentage points from the second quarter. Among respondents who identified administration as the largest burden, 27% pointed to prior authorization as the biggest contributor, compared with 31% in the prior quarter. Those changes are incremental, but they suggest the most contentious part of the payer-provider relationship may be softening at the margins.
One sentence captures the tension plainly: prior authorization remains a dominant source of distrust.
Nelson said the company’s efforts are not limited to surveys. Aetna has also been hosting forums that bring together leaders from hospitals and health systems to talk through where the relationship needs to go next. He described the broader effort as a coalition of the willing rather than a solution imposed on the industry, a framing that reflects how difficult it is to make durable progress without buy-in from both sides. Federal officials have also shown interest in getting payers and providers aligned on initiatives such as faster determinations and more electronic pathways for approvals.
The logic is straightforward. If coverage decisions can move through digital channels with fewer manual handoffs, then both sides have a better chance of cutting delays, reducing staff time spent on administrative back-and-forth, and limiting the kind of uncertainty that can interfere with treatment. In practice, the payoff depends on whether electronic tools are truly interoperable and whether providers can exchange the right information without duplicative work. Nelson said the next stage will require other stakeholders, including electronic medical records companies, to help unlock interoperability that drives further change.
The survey also suggests providers are receptive to that direction. Twenty-five percent said interoperability can improve outcomes, up seven percentage points from the second quarter. That response is especially relevant in a system where fragmented data often forces clinicians to operate with incomplete information, while payers are asked to make coverage decisions without full visibility into the clinical context. Interoperability will not solve every dispute, but it can reduce avoidable ambiguity and shorten the time between request and determination.
Fraud prevention emerged as another area with unusually broad agreement. Ninety-four percent of providers said fraud is a critical challenge for the healthcare system, and nearly 60% said addressing fraud could significantly reduce healthcare costs. Close to a third, 30%, said payers should use artificial intelligence to identify potentially fraudulent claims, while nearly 90% believed payers can substantially reduce fraud, waste, and abuse each year.
The fraud findings fit a larger pattern in which providers appear willing to support payer efforts when the goal is cleaner administration rather than one-sided restriction. Fraud drains resources from every part of the system, drives up costs, and can distort coverage conversations when legitimate care gets caught in the same review channels. A stronger analytic screen for suspicious claims could improve efficiency if it is deployed carefully and paired with safeguards against unnecessary denials or overcorrection.
Nelson also connected the issue to the current federal focus on fraud mitigation. He said providers do not want to be viewed negatively, and health plans do not either. The shared incentive is to keep bad actors from inflating costs without punishing the clinicians and organizations that are trying to deliver care within the rules.
Aetna’s survey results do not signal a full reset in payer-provider relations. They do suggest that repeated attention to the mechanics of prior authorization, electronic review, and clearer communication can change how providers judge insurers over time. The most important question is whether those improvements can hold as the industry moves beyond incremental trust gains and into the harder work of scaling interoperability across health plans, providers, and technology vendors.