How Field Reimbursement Metrics and Models Evolve in the Real World

As manufacturers continue to invest in field reimbursement manager (FRM) programs, the pressure to prove value has never been higher. Leadership teams want clear, defensible metrics that tie directly to patient access, speed to therapy, and overall program effectiveness. That shift is forcing organizations to rethink not only what they measure, but how they distinguish between meaningful impact and operational noise.

In the second and final part of her interview with Pharmaceutical Commerce at Access USA 2026, Kimberly Howard, senior manager of Field Reimbursement Services at CoverMyMeds, emphasized that the most persuasive KPIs are those that track the full lifecycle of a patient’s access journey. From prior authorization (PA) submission rates and outcomes to appeals progression and overturn success, these data points offer a more complete picture of how FRMs influence access. Equally important is turnaround time—how quickly a PA moves from submission to approval—which directly correlates with how fast patients can begin therapy. Together, these metrics shift the conversation from effort to outcomes.

At the same time, Howard cautioned that even the most robust measurement strategy can fall short if the underlying FRM model is misaligned from the start. One of the most common missteps manufacturers make is over-engineering their approach before fully understanding the access landscape. Especially at launch, payer behavior, denial patterns, and regional variability are often unclear, making it difficult to predict where support will be needed most.

Instead, a more effective approach is to start with a focused, flexible model and scale based on real-world insights. As programs mature, differences in regional access barriers, volume demands, and payer dynamics become clearer—allowing teams to allocate resources more strategically. In this way, both measurement and model design become iterative processes, evolving in tandem to ensure FRM programs deliver measurable, meaningful impact where it matters most: getting patients on therapy faster and more efficiently.

Access the first part of her interview with PC below:

• Aligning Hub Services and Field Reimbursement Teams for Better Patient Support

A transcript of the conversation can be found below.

PC: What key performance indicators have you found most persuasive with leadership when demonstrating FRM value — and how do you separate true impact metrics from activity-based ones?

Howard: I think this is something every customer that we deal with asks, and it really comes down to what their KPIs are. We have some great insights because with CoverMyMeds, we have access to the portal. And so our impact reporting really is based off of what does the PA submissions look like? What does the outreach look like from an FRM and from that outreach, did that PA get approved? Did it get denied? If it got denied, did it move to an appeal? If it moved to an appeal, was it overturned? Did you get it approved? So I think some of those are really the important aspects. I think turnaround time is an important aspect that they want to measure. Once a PA is written, how long does it take to get processed and, and get that patient on therapy? So I think those are some of the key KPIs that they look at right now from, from that FRM perspective and the impact that we make.

What's the biggest mistake companies make when deciding between a full-service FRM model and more specialized field roles?

I think that, from what I've seen, it's really trying to create that model before you really know what's going on. and so if you're able to, you know You don't always know the barriers that you're going to experience when you're starting an FRM program. A lot-- Specifically with a new launch, you're not often, knowing what are going to be the payer policies, what's going to get denied, how frequently is it going to get denied. And so therefore, I think you look at maybe starting a little bit smaller and you scale up as needed. As you determine what those barriers are, you understand where are the needs. You know, we see a lot in some of our programs. where East Coast has a lot more barriers than the West Coast does, and there's a lot more volume in certain areas. So I think volume comes into play as well when it comes to that.