Step Therapy & Alternative Approaches. In an effort to control health care costs, payers use multiple mechanisms to steer the patient towards less expensive therapies. Step therapy, also known as “failed first protocol” or “tiered therapy” or “graduated therapy” is a type of prior authorization (PA) instituted by the payer that mandates that more cost-effective therapies be used before more expensive alternatives in a stepwise approach. Prior authorization can be burdensome on providers especially if streamlined processes are not implemented within the clinical workflow. The CME Outfitters, LLC Ophthalmology Hub is designed to provide clinicians with the latest guidelines to optimize the management of patients with AMD and resources on step therapy. In addition, the Ophthalmology Hub also includes a patient whiteboard that educates patients on the step therapy process.