Aetna’s CMO on the plan to win back providers’ trust

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Health insurers are eager to regain patients’ and providers’ trust, but they have a long road ahead.

Government investigations over the last few years have alleged major payers were improperly denying prior authorization (PA) requests, particularly for costly post-acute care, and potentially with the help of AI algorithms that lacked adequate clinician oversight.

Payers have made attempts to win back trust through initiatives like a June 2025 pledge to improve PA. But that year, just 1 in 3 physicians told the American Medical Association they thought the 2025 commitment would make a “meaningful” difference for patients and physicians. Then in May 2026, nearly 30 healthcare organizations, including payers, pledged to be early adopters of new electronic PA requirements that will roll out in 2027.

Survey results shared in a July 15 press release by CVS Health’s Aetna suggests trust has increased slightly. PA is still a source of concern, however: 84% of survey respondents ranked administrative burden as their top challenge, pointing “overwhelmingly to managing patient records or prior authorization” as the source of the burden, according to the release.

Benjamin Kornitzer, chief medical officer of Aetna, told Healthcare Brew the survey results make him optimistic. He said Aetna will continue to work to regain provider trust, and technology may be a key tool.

This interview has been lightly edited for length and clarity.

Where do you think providers’ mistrust of health insurers originates?

Historically, healthcare has been a zero-sum game. What’s happened over the past few years, as value-based care has evolved, it’s really transitioned payers to become solutions companies, and it’s turned us from being transactional to being partners. And so we are deeply invested in making sure that our providers have all the tools that they need to give the best outcomes to our members. We do that through a whole series of activities. We work through value-based care arrangements. We have quality metrics. We have joint operating committees…and when you do that, it resets the conversation.

So do you feel there were inherent problems in the health insurance industry, or do you feel the lack of trust is primarily a perception issue?

As you go to the executive levels and you see the conversations between provider executives and payer executives, they are tremendously collaborative, and there’s a tremendous amount of action, of understanding, and appreciation of the capabilities and the skills that each one brings. I think what’s different as we move forward is…so many of the things that were administrative burden—whether it’s delays in prior authorizations, whether it’s workflows—increasingly those are moving at the speed of technology. I think it’s removing a lot of those points of friction, and that’s also changing the dynamic and the dialogue very significantly. At the end of the day, we have more in common than we have apart, and I think that acknowledgement, and our ability to get better outcomes for our members, is really advancing the relationship very significantly.

What does a trusted relationship between payers and providers look like, and what hurdles still need to be overcome?

We’re all in this together, and when there is a disconnect between providers and payers, patients feel it, and their experience shows [it]. What I think you have to do if you really want to build trust is you have to listen. And so I would begin by saying this survey is an indication that we want to understand the pain points that providers have, and we want to be the best partner possible. Healthcare is in a moment of tremendous change. It’s putting stress on providers. It’s putting stress on payers. It’s making healthcare more challenging and less affordable nationally. But we’ve got an opportunity to work differently together.

So the fact that trust is increasing allows us to do a few things. It allows us to get data from providers back to us so that we can make faster decisions.

Aetna and other payers have increasingly integrated AI into the PA review process. Some physicians worry AI is driving up denials of PA requests. How are you proving to providers that isn’t the case?

We will always have decisions made by physicians. We believe in responsible AI. We don’t think that AI will ever replace clinical judgment. Every single person is unique, and every single case is unique, and we need compassionate, caring, trained clinical experts to make those decisions. What AI can do is speed things up in a way that approves things faster. Imagine the ability to get real-time decisions. Imagine the ability to get more durable decisions, so that we know that when we are making a decision and making an approval, it is the right decision, and we’re able to communicate that more quickly, more effectively. And anytime there is an adverse decision, we make sure that there has been a clinician in the loop looking at the specifics of that case.

The majority of providers (68%) surveyed by Aetna said interoperability and data integrity was their top technology challenge. How does Aetna plan to tackle that?

Interoperable bidirectional data is absolutely critical to creating better member experiences.

CVS, as an organization, has committed to a $20 billion investment over a [10]-year period in technological innovation, and one of the major drivers of that is creating all of the plumbing and technology so that we can exchange that data seamlessly.