Prior authorization is often cited as a major pain point in healthcare—but it doesn’t have to be. In this conversation, Dr. Michelle Gourdine, Chief Medical Officer at CVS Caremark, shares how Caremark is transforming the prior authorization experience through automation, clinical rigor and responsible use of artificial intelligence.

Dr. Gourdine explains why prior authorization remains an important tool for ensuring medications are used safely and appropriately while acknowledging the burden it can place on providers and patients. She details how Caremark has reduced median processing times from hours to minutes, processed millions of requests at scale and proactively renewed approvals to avoid treatment disruptions.

The discussion also explores how AI is being applied in a clinician‑decides model, supporting faster decisions without ever being used to deny care. From specialty drugs to high‑cost therapies like GLP‑1s, Dr. Gourdine outlines how clinical evidence, affordability and patient outcomes guide every decision. The result is a more efficient, transparent approach to prior authorization that keeps care moving forward.

Prior authorization is often cited as a major pain point in healthcare&mdash;but it doesn&rsquo;t have to be. In this conversation, Dr. Michelle Gourdine, Chief Medical Officer at CVS Caremark, shares how Caremark is transforming the prior authorization experience through automation, clinical rigor and responsible use of artificial intelligence.
Dr. Gourdine explains why prior authorization remains an important tool for ensuring medications are used safely and appropriately while acknowledging the burden it can place on providers and patients. She details how Caremark has reduced median processing times from hours to minutes, processed millions of requests at scale and proactively renewed approvals to avoid treatment disruptions.
The discussion also explores how AI is being applied in a clinician‑decides model, supporting faster decisions without ever being used to deny care. From specialty drugs to high‑cost therapies like GLP‑1s, Dr. Gourdine outlines how clinical evidence, affordability and patient outcomes guide every decision. The result is a more efficient, transparent approach to prior authorization that keeps care moving forward.

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

Podnosis

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

Automation, AI and clinical oversight are cutting prior authorization times without compromising patient safety.