- Center on Health Equity & Access
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Episode 9 - The Payer Approach to Immunotherapy
In this segment, the panelists explain how coverage policies vary by payer, and explore the factors that affect the costs associated with different immunotherapy agents.
Michael Kolodziej, MD, discusses how Aetna reviews evidence and takes several factors into account when making payer decisions about supporting cancer research, and explains that different organizations have different processes. Jeffrey Weber, MD, PhD, continues the conversation with an explanation of how different immunotherapy agents have different dosage and administration requirements, which affect overall costs.
Addressing cost differentials and coverage policy inconsistencies is important because what is covered by payers directly impacts the types of treatments that are recommended to patients. As concluded by Daniel J. George, MD, providers want to be able to recommend a clinical trial or other treatment modality in situations where standard therapy is not likely to be effective for the patient.
Stuck in Prior Auth Purgatory: The Hidden Costs of Health Care Delays
June 19th 2025Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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Culture Key to Data Collection of Sexual Orientation and Gender Identity in Cancer Care
June 23rd 2025This research highlights the key factors, like leadership buy-in, mandatory protocols, and electronic health record workflows, that influence the effective collection of data on sexual orientation and gender identity in outpatient oncology clinics to improve patient-centered care.
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