Protecting Patient Access Amid Site of Service Policy Changes | AMCP Annual 2025

At the AMCP 2025 annual meeting in Houston, Sean Shirk, Pharm.D., director of specialty clinical solutions at Prime Therapeutics, discussed on Tuesday how payers can sustain site-of-service (SoS) efforts even with increasing legislative restrictions.

His session, "Legislative Impacts on Site of Service: What is the Big Deal?" highlighted key strategies and calls to action for stakeholders.

Shirk discussed the importance of staying informed and engaged with both state and federal legislation.

“Get involved in the state that you service. Track what their legislation is, track federal legislation,” he advised.

Shirk also pointed to resources from organizations such as the American Society of Clinical Oncology (ASCO) and the Academy of Managed Care Pharmacy (AMCP), which provide tools for tracking bills and mobilizing action when policies threaten to impact patient care.

The core concern he mentioned is ensuring that site-of-service policies prioritize patient well-being.

When legislation forces patients into higher-cost hospital outpatient settings rather than more affordable, convenient alternatives, access to treatment can suffer.

“What we want to avoid is seeing site-of-service legislation that impacts the patient where they're not being shifted to a lower-cost, more convenient site of care,” he said.

A patient struggling with infliximab infusions due to high costs and travel burdens was able to resume therapy with improved affordability and convenience after transitioning to a home-based setting, as Shirk shared in a real-world example.

With legislative pressures weighing heavy, Shirk urged payers and healthcare stakeholders to advocate for policies that promote flexible, patient-centered care models.

By staying informed and taking action, the industry can help protect access to cost-effective, high-quality treatment options.