Prior authorization is one of healthcare’s most persistent friction points. R1’s acquisition of Humata Health is designed to strengthen the pre-bill architecture and move the revenue cycle upstream — preventing delays, denials and administrative burden before they occur.
Prior authorization slows care and demands a better answer
In healthcare, delayed authorization is more than an administrative setback. Patients may wait longer for care, clinicians and provider teams absorb more manual work, and payers receive incomplete or inconsistent requests that require avoidable follow-up. Prior authorization remains one of the most persistent sources of friction across the healthcare ecosystem — and one of the clearest opportunities to create shared value.
That is why R1’s acquisition of Humata Health marks an important step forward for the industry. By bringing Humata Health’s AI-powered prior authorization technology into the Phare Operating System, R1 is advancing a more connected, intelligent pre-bill architecture. The goal is to shift revenue cycle workflows to the left by optimizing AI, clinical data and payer intelligence to prevent administrative friction, care delays and revenue leakage before they occur. Despite inflation, an ounce of prevention is still worth a pound of cure.
Why prior authorization has become a breaking point
The challenge is urgent. According to KFF’s February 2026 Health Tracking Poll report, nearly seven in ten insured adults say prior authorization is a burden when it comes to getting healthcare, and one-third identified it as the biggest burden they face when accessing care. At the same time, prior authorizations are a top-three driver of denials, creating a ripple effect that impacts clinicians, provider organizations, payers and patients alike.
It is also a system-wide coordination problem. Payer policies change frequently, requirements vary by service and plan, and appeals consume time and resources. Even when authorizations are ultimately approved, the path there can delay patient care, divert clinicians and provider teams from higher-value work and force payers to process preventable rework. KFF analysis of 2025 insurer data found that insurers denied between 12% and 18% of standard prior authorization requests across major market segments. Among appealed standard denials, 67% were overturned in Medicare Advantage, 47% in Medicaid managed care and 43% in the ACA Marketplace. The need for a better process is clear. For R1, solving it starts upstream.
Strengthening the intelligence foundation of Phare OS
Phare OS, R1’s AI-native operating system that created proactive revenue cycle management through smarter and faster decisions for authorizations, utilization review, documentation, coding and more. Its foundational intelligence layers — Phare Intelligence and Payer Atlas — bring together clinical, operational and payer data to guide these pre-bill workflows, reinventing the revenue cycle that optimizes itself and gets smarter with every claim.
Humata Health’s world class performance in prior authorization directly enhances the speed and effectiveness of Phare’s pre-bill workflows. Its authorization policy monitoring and agentic submission capabilities help interpret changing payer requirements, assemble the right supporting documentation and move requests efficiently through the authorization process. Combined with Phare Intelligence and Payer Atlas, those capabilities turn payer rules and clinical data into more proactive, precise action.
“Humata Health, in my view, has the best authorization technology in the market,” said Steve Albert, executive vice president and chief product officer at R1. “It’s agentic, it’s AI native, it’s embedded in the EHR, and it’s aligned with our vision of how an integrated operating system should work.”
This is the strategic logic behind the acquisition. R1 can extend an AI-first pre-bill architecture with purpose-built technology for one of healthcare’s most complex and manual workflows. Rather than treating prior authorization as a stand-alone task, the combined platform can identify and resolve friction earlier — before it becomes a denial, a delayed procedure or unnecessary administrative work.
How Humata Health improves prior authorization in Phare OS
In practical terms, this all means less reliance on paper, portals and repetitive manual follow-up. It means more intelligent workflows that can determine requirement logic, create AI-driven clinical bundles, provide evidence for payer attestations and manage requests through final approval across specialties. It also means greater connectivity between providers and payers, helping move the industry closer to real-time authorizations and adjudication.
Humata Means Authorization Excellence
96% first-pass approval rate
83% reduction in rescheduled appointments
45% reduction in staff touches
The addition of Humata Health helps R1 strengthen the pre-bill architecture of Phare OS, moving audit workflows to precede final billing to benefit providers, payers and patients alike. Providers slash preventable denials, driving faster authorizations at lower cost. Payers get cleaner claim submissions, more complete documentation and increased electronic submission rates. And patients benefit by receiving timely care with less worry about post-discharge billing problems.
Humata Health’s results underscore the potential impact. Its platform enables providers to achieve up to a 96% first-pass approval rate, rescheduled appointments by 83% and staff touches by 45%. The benefits extend across the ecosystem — patients face fewer delays, clinicians and provider teams spend less time on manual follow-up, and payers receive cleaner submissions with more complete documentation and fewer avoidable interactions.
Built by someone who lived the problem
Deep healthcare revenue cycle expertise is central to R1’s value proposition and to building a revenue operating system that works in practice. Humata Health was likewise created in response to the reality of prior authorization by a leader who experienced the problem firsthand.
“As a physician, I’ve seen firsthand how prior authorization delays drain providers and push an already strained healthcare system to a breaking point,” said Jeremy Friese, MD, founder and CEO of Humata Health. “Fixing this broken process is urgent.”
That urgency and that practical understanding of the problem make Humata Health a strong strategic complement to R1. Friese’s perspective as a practicing radiologist helped shape an AI-native platform grounded in real clinical and operational pain. R1 brings scaled revenue cycle expertise, broad provider relationships and operational reach. Together, those strengths can accelerate adoption and prevent friction before it becomes a denial, care delay or unnecessary work.
Aligned in more than technology
The fit extends beyond technology. Humata Health is a physician-led company with a mission to make prior authorization seamless for providers, payers and the patients they serve. That perspective aligns with R1’s mission to make healthcare work better for all. It also creates a strong foundation for combining Humata Health’s AI-native platform with R1’s revenue cycle expertise, provider relationships and scaled operations.
“I’m super excited about the addition of the Humata Health team,” said Albert. “They have tremendous technology, go-to-market and customer support and service teams that I think will be a great fit for R1 and will enhance our ability to serve clients and make sure we deliver value for them.”
Albert also highlighted Humata Health’s work to bridge longstanding disconnects across the healthcare ecosystem. “They’ve been very focused on not only solving the authorization problem for providers, but also helping to bridge that gap between payers and providers to make the entire process better for all constituents,” he said.
Toward more connected, real-time authorizations
The Humata Health team will enhance R1’s R37 innovation lab and agentic AI development team. Together, they will connect Humata Health’s technology to Phare OS and accelerate AI-powered automation across the revenue cycle. For providers, that creates the potential for a more integrated pre-bill architecture with broader automation, smarter use of data and minimal incremental integration for additional modules.
Over time, the combined platform can create increasingly powerful intelligence that learns across the revenue cycle. Insights from payer policies, authorization outcomes, clinical documentation and downstream performance can improve both upstream and downstream decisions, helping patients access care sooner, enabling providers to reduce preventable work and revenue leakage, and giving payers cleaner, more complete submissions.
The long-term vision is to reduce friction before it becomes a delay, denial or patient dissatisfaction — and to accelerate adoption of advanced authorizations across a broader provider footprint. By combining automation, AI, clinical context and human expertise, R1 and Humata Health can make authorizations more intelligent, connected and seamless while strengthening decisions throughout the revenue cycle.
