Pricing & Reimbursement

Services

Strategic Planning

• Strategic planning to achieve access
• Payment environment assessments
• Competitor reimbursement analyses
• Multi-payer access development
• Reimbursement/pricing issue analyses
• Medicare/CMS advocacy
• Pricing studies
• Competitor assessments
• Payer/provider market research
• Formulary access planning
• Payer mix analyses & reports
• Medicare demonstration & Medicaid waiver requests

Pre-Launch Support

• Launch-to-payer planning
• Coding & billing strategies
• Advisory boards
• Reimbursement pull-through program design
• Reimbursement & patient assistance program design
• Foundation design & management
• Reimbursement & pricing strategies, tactics and messages

Product Launch

• Payer education
• HCPCS/CPT/ICD-9-CM code applications
• Filings & registrations
• International reimbursement/economic analyses
• Reimbursement sales training
• Reimbursement seminars and workshops
• Managed care contracting strategies
• Coding & billing guides
• Value-added reimbursement programs
• Case management hotlines
• Coordination with CMS

Post-Marketing Access Management

• Provider reimbursement support programs
• Patient reimbursement support programs
• Reimbursement support hotlines
• Access & reimbursement problem/issue resolution
• Cost of illness/burden of illness models
• Payer advocacy networks
• Inpatient DRG analysis

Communications

• Formulary & payer education kits
• Payer monographs
• Reimbursement tool kits
• Program brochures and launch materials
• Reimbursement sales training materials
• Reimbursement workshops
• Interactive and web applications

Data Analysis & Special Studies

• Survey research, including data collection and analysis
• Claims and payment trends via analysis of public use file data
• Cost estimates using same methodology as Congressional Budget Office (CBO) and CMS’ Office of the Actuary
• Industry-specific databases built to allow analysis of and response to complex public policy questions