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Medical Device Reimbursement

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Healthcare Marketing Center of Excellence

Medical Device Reimbursement

Need help with Market Development, Digital Marketing, Social Media, and Physician Engagement (Thought Leader Development)? Look me up on Linked In - Simon Sikorski M.D.

When it comes to medical device reimbursement discussions for 2011 & Beyond there are two most important strategies a company must undertake:

Clinical Research: Aside from at least 8-10 company-run research and publications about the benefits of your product, a company must support Comparative Studies, and do so very early, preferrably even before marketing and sales. The important point here is that the most influential comparative studies are ones that are run by non-company-sponsored practitioners and preferrably in different market segments across the country. Payers' first questions are about studies! Their second round of questions is about the validity of those studies.

Involvement of Inventor in marketing, sales, and speaker programs: Should the inventor involve himself in the company's operations it gives instantaneous credibility to its products. Should an organization launch a product without such support it will fight extreme uphill battles to win adoption.

Thought Leadership (not Market movers): As we spoke about the innovators and early adopters who move markets, payers are rather looking toward respected and already established therapeutic area Thought Leaders. Their opinions about products and treatment algorithms are golden. Investing in management of thought leaders and offering options for comparative studies, advisory board memberships, and supporting services for therapeutic area events are the way to win them over.

Treatment Algorithms: Payers are most interested in saving money. If your organization is proactive in demonstrating to payers that there is no guess-work as to the steps in disease management, it's almost an automatic win. In many therapeutic areas, treatment algorithms vary to such extent that there could be 20-30 different products that are used in the first disease management steps. Gaining Thought Leaders and market movers who'd influence disease mangement algorithms in their local markets is a very advanced strategy that takes very careful planning. 8 years of our research and work with 31 medical device companies went into development of treatment algorithm strategies. Email us or Call Today: (646) 648 - 1355

No CPT Codes? Reimbursement issues? ... No Problem

If you're one of the many medical device manufacturers without a CPT code, if payers are still deeming the use of your devices as experimental even in light of thousands of procedures, if your surgeons' reimbursement has dramatically decreased ... why worry? That's only 100 million people in the marketplace that fit into the "insured" model.

Almost 200 million Patients in the U.S. are now seeking self-pay options. Why?

There are 59 million people without insurance. Do these people need medical services and treatments where your devices fit... YES. Are they willing to pay for it ... YES.

There are over 70 Million people with catastrophic coverage insurance. These are the people that are forced to pay out of pocket for everything outside of hospitalization. Do these people need therapies where your devices can change their quality of life? Yes. Are they willing to pay out of pocket for them ... YES.

There is another 50-80 milion people in the U.S. who have High Deductible Plans and rather than seek medical services they are avoiding care because they don't have the money to pay out of pocket.

What about all the people with pre-exisiting medical conditions? What about immigrants? What about concierge medicine or medical tourism patients? All these people are willing to pay of out pocket.

When patients pay out of pocket, the decision to use certain equipment over another is completely between the patients and the providers. There are no middlemen. There are no third parties that destroy the progress of medicine.

Healthcare Marketing Center is an initiative started by Simon Sikorski MD to help medical organizations find resources on Healthcare Marketing and connect them with Medical Marketing Experts.