The IDI

A Payer’s Perspective on Prior Authorization

Episode Summary

Our recent episode about prior authorization was one of our most popular episodes so, to continue the conversation, we invited a payer executive, Dr. Andrew Hertler, on to the podcast get his perspective. Hertler is Chief Medical Officer at Evolent Health. Hertler recently co-authored an op-ed about prior authorization. In it, he touched on gold-carding, a controversial solution to addressing prior authorization challenges.

Episode Notes

What do payers think about prior authorization? 

Dr. Andrew Hertler is Chief Medical Officer at Evolent Health. He recently co-authored an op-ed about prior authorization, touching on gold-carding, a controversial solution to addressing prior authorization challenges. 

Joining Hertler is regular guest John Hennessy, a Principal with Valuate. 

Topics include:

• Why exceptions can sometimes be problematic.
• What happens after a prior authorization is rejected.
• Pathways: Who makes the decisions? How are they updated?
• How should pharma  think about payers?
• What can manufacturers and market access do to help pathways?

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