Medical Device Marketing

Payer Market Research

The market for your medical device extends well beyond physicians, hospital facilities and patients, it includes the payers who reimburse for the products. Understanding how to present your technology to the third party payers is critical to successful product launch and sustained success in the medical market place.

When do you approach a payer and what data do they require in order to develop positive coverage policies? This question requires careful consideration. Premature contact with the payers may inadvertently compromise your product’s success. Reimbursement Principles is uniquely positioned to assist medical device manufacturers with introducing new technologies for positive coverage policy development. Interfacing between the manufacturer and the payer – this is where Reimbursement Principles’ expertise counts.

Payer-Mix Assessment:

Who pays for the disease state your technology is designed to diagnose or treat? Fundamental to identifying a reimbursement/payer strategy is an understanding of the payer market. For example, if your medical device is designed to ablate breast and prostate tumors, you’ll benefit from know the following facts:

Coverage Research:

What are the payer’s terms and conditions relevant to your technology? Will they automatically cover your product once you have FDA clearance/approval? No! Payers require much more than the FDA’s authorization to the market the product in the US. They require evidence of improvement over standard medical practice, outcomes data, widespread clinical support, and more. Payer coverage is usually the most critical reimbursement element to consider yet it is frequently overlooked by medical device

Payer Medical Director Focus Groups:

Have you ever wondered what a payer medical director would say about your medical technology? Reimbursement Principles is associated with several payer medical directors who can provide commentaries on your product. Will they pay for it, if not, why not and what is required to change their mind?

Payer Dossiers:

What data and information should a manufacturer present to the payers? Reimbursement Principles has extensive experience putting together the right data, training staff and providers on how to present the information when face to face with the payer’s decision makers.

Health Economics, Quality of Life Scores, And Comparative Effectiveness Data:

The payers require data substantiating the cost effectiveness of medical technologies. Make sure your product meets the payer’s requirements. Our health economists and outcomes planners are adept at framing the economic value proposition to the payers.

Preauthorization:

One of the most powerful and efficient means of educating payers about new technologies is through preauthorization. Reimbursement Principles can teach your physician customers on how to preauthorize, using successful tried and true techniques. If your providers don’t want to take on preauthorization, Reimbursement Principles can. Using HIPPA compliant practices, we can assume preauthorization services.

Appeals:

Appealing denied or low paid claims can be a daunting proposition for medical device manufacturers who are focused on other areas of their business. Yet, appealing claims is another powerful way to develop positive third party payer coverage policies. As with preauthorization Reimbursement Principles can teach you how to successfully appeal denied cases, or we can provide the service using HIPPA compliant methods.