Pillar 5: Clear Pathways to Care

Patients shouldn’t be blocked from the care they’re already prescribed. Even with a diagnosis, coverage, and treatment plan, too many patients are stopped by insurers and systems that impose hurdles to care. This pillar eliminates those barriers, whether built by PBMs, AI algorithms, or coverage design, so that once a patient enters the care system, nothing stops their way.

The policy priorities listed below will change in the coming months as HFA works to redesign our policy work and provide the community with new education and policy documents.

• Copay Maximizers vs Accumulator Adjustors: What’s the Difference?
• Copay Maximizers
• Accumulator Adjuster Programs
• Access to DDAVP Nasal Spray
• Step Therapy & Mid-Year Formulary Changes
• Prior Authorization