Navigating the complex web of payors, prior authorization processes, and pharmacy benefit managers (PBMs) has become a daily operational challenge for pharmacy leaders across IDNs. These three forces significantly impact patient access, drug reimbursement, and the overall efficiency of pharmacy services – often in ways that can be misaligned with clinical and financial goals.

Join pharmacy experts and break down how each “P” influences pharmacy operations and revenue cycles, providing real-world insights into policy trends, payor negotiations, and authorization barriers. 

Learning Objectives:
1. Describe the distinct roles that payors, PBMs, and prior authorization processes play in influencing pharmacy reimbursement and patient access.
2. Analyze how policy shifts and payor behaviors are shaping prior authorization requirements and timelines.
3. Differentiate the strategies IDNs can use to manage payor and PBM relationships more effectively.
4. Construct an action plan to streamline prior authorization workflows and reduce operational inefficiencies.