The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) recently announced the creation of a new Healthcare Advisory Committee—a group charged with improving how care is financed and delivered under federal insurance programs.
The committee’s mandate includes reducing administrative burden, modernizing Medicare Advantage, and identifying new ways to improve quality in Medicaid. On paper, that means streamlining red tape and letting providers focus on outcomes. In practice, it raises an important question: Are patient support programs ready to deliver that efficiency today?
Why This Matters for Patient Services
For providers, “less paperwork, more patient care” is a welcome message. But it also means manufacturers will be expected to design patient services that:
- Reduce administrative friction for prescribers and staff
- Compress time-to-therapy with smarter, connected workflows
- Track outcomes with the same rigor regulators demand
- Balance compliance with flexibility to evolve as measures change
If CMS redefines reporting requirements, or shifts how quality is measured, pharma can’t afford to wait for new rules to trickle down. Patient support programs must already be building in the agility regulators are calling for.
The Risk of Standing Still
Too many programs still rely on:
- Manual workflows that slow access and frustrate providers
- Rigid free-goods models that can’t adapt to alternative funding pathways
- Disconnected systems that add compliance risk instead of reducing it
If CMS is serious about cutting administrative burden, programs that add more complexity will quickly fall out of step with payer and provider expectations.
How to Prepare
Forward-looking manufacturers are investing now in tech-enabled, patient-first services that align with CMS’s stated goals:
- HealthPACER® Case Management: End-to-end workflows for benefit verification, ePA, appeals, and patient engagement—reducing time-to-therapy.
- PAP Calculator: First-of-its-kind functionality to streamline eligibility, explore alternative funding, and ensure compliance.
- Hybrid Models: Flexibility to insource, outsource, or blend services while maintaining efficiency and control.
- Real-Time Reporting: Custom dashboards that support audit readiness and outcome tracking.
Looking Ahead
The Healthcare Advisory Committee may take months or years to finalize its recommendations. But the direction is clear: efficiency, outcomes, and reduced burden will drive the next phase of federal payer policy.
Patient services can’t be an afterthought. They are where policy goals meet the patient journey—and where manufacturers have the power to show regulators and providers what streamlined, outcome-focused support really looks like.
At eMAX Health Patient Services, we design programs that bring together technology, compliance, and human expertise to meet that standard today.
Is your patient support model ready for what’s next? Let’s talk.
info@emaxhealthps.net | www.emaxhealth.net