AJMC March 8, 2025
Experts shared details on health care contracting, setting up a centralized prior authorization pilot, and use of advocacy to win PBM reforms at the state level.
In recent years, advances in clinical oncology have been offset by administrative burdens: more requirements from Medicare, more quality improvement tasks from payers, and especially more proof that a patient needs a drug or test before reimbursement happens.
Speakers at the Association of Cancer Care Centers’ 51st Annual Meeting & Cancer Center Business Summit session, “Payer-Driven Challenges and Solutions,” reviewed strategies to deal with common complaints such as prior authorization and being shortchanged on contracts. And increasingly, oncologists and cancer center leaders are heading to their state legislatures for relief. Susanne Tameris, MHA, senior...
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