Maximizing revenues requires market insight and an understanding of pricing and reimbursement policies combined with system economics analysis and creative strategic thinking. The distribution channels and payment rules are different in each segment of the healthcare industry – drugs, devices, diagnostics and services – but the fundamentals of quantifying clinical and economic value to determine a product or service’s optimal price and drive reimbursement coverage apply to all four segments.
Health Advances’ reimbursement knowledge is constantly updated by our internal staff. We have also assembled a panel of external experts, from Medical Directors and Technology Assessment Executives at regional and national-level payer organizations, to coding and reimbursement specialists working in hospitals, freestanding clinics, and physician offices, to third party utilization and preauthorization firms. Each pricing and reimbursement study leverages these resources to ensure the most up-to-date understanding of the relevant payments for medical products and services, supported by rigorous comparative cost and effectiveness research, in order to validate and support pricing decisions and coverage requests.
View our Reimbursement and Pricing Strategy case examples