The Complexities of Prior Authorizations, a Panel Perspective

MPhA Continuing Education Program and Town Hall Event

The cost of health care continues to rise faster than inflation. For many health plans the cost of medications has now exceeded inpatient costs. High priced and specialty drugs are over 60% of the total pharmacy spend. Managed care provides a valuable and necessary service to containment of health care costs. We all agree that we must keep health care affordable. When medications require Prior Authorizations through health plans or pharmacy benefit managers, patient care providers including clinicians and pharmacists are on the front lines. Often they must deliver this message to their patients and begin a seemingly unending process of red tape. Pharmacies and clinics spend significant time and resources trying to navigate the prior authorization process. Emotions tend to run high on both the side of the health plans and the care providers. This panel discussion will convene key stakeholders willing to have open and honest dialogue about how we could improve this process for all.

Learning Objectives: The participants will

• Understand how the cost of medications, from a population perspective, are contributing to the rise in health care costs.
  
• Understand how varied and complicated processes create barriers to timely information exchange and efficient patient care.
  
• Apply process principles to promote better workflows and effective patient communication.
  
• Create new communication paths to improve the process of prior authorizations for drug therapy.

**Times subject to change

Cost

Complimentary for Members
$25 for Non-members

Moderator

Molly Ekstrand, RPh, BCACP, AE-C, Park Nicollet Medication Management Program Lead. Molly started her pharmacy career in community pharmacy, moved into comprehensive medication management practice in primary care clinics, then became a leader in a large self-insured employer group aligned with a health plan. She truly understands perspectives on both sides and wishes to promote healthy dialogue.

Panelists

• Susan Cooper, Pharmacist, HealthPartners, Senior Director of Pharmacy Plan Services
  
• Julie Freeman, Pharmacist, Cub Pharmacy, St Louis Park
  
• Amanda Robinson, Pharmacy Technician Patient Access Services Manager at Fairview Pharmacy Services
  
• Laura Odell, Pharmacist, Mayo Health Solutions, Self-Insured Employer Group, involved with Managed Care
  
• Dave Hoang, PharmD. MBA, Clinical Pharmacist, Pharmacy Administration, MN DHS