Director, Specialty Clinical Solutions Prime Therapeutics Oviedo, FL
Disclosure(s):
Connie Estep, PharmD, BCGP: No relevant disclosure to display
Sean Shirk, PharmD: No financial relationships to disclose
This session will provide a comprehensive overview of site of service (SOS) legislation and its impact on managed care organizations and patient care. Participants will explore how varying state regulations limit insurers in mandating specialty medication sources and how they reshape managed care strategies nationwide. Speakers will delve into how health plans are adapting their strategies in response to these legislative restrictions and how to balance cost control with patient access and legislative compliance. Insights into effective approaches and potential challenges for SOS programs in the context of state legal restrictions will be provided. The session will also examine the influence of SOS programs on patient experience, emphasizing access, affordability, and overall satisfaction. Speakers will conclude with a call to action for the managed care community, emphasizing the importance of innovation, advocacy, and collaboration to navigate the evolving legislative landscape while prioritizing patient outcomes and cost containment.
Learning Objectives:
At the completion of this activity, participants should be able to:
Describe the impact of State site of service (SOS) legislation on managed care organizations.
Identify health plan strategies to address challenges posed by these legislations.
Explain the role of SOS programs in shaping patient experience.
Summarize call to action items for the managed care community.
