how medtech companies get paid: understanding reimbursement basics and how startups successfully...

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How MedTech Companies Get Paid Understanding reimbursement basics and how startups successfully navigate the US medical system

Post on 14-Sep-2014

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Join Zack Miller, Head of the Investor Community at OurCrowd, and Fauzea Hussain, VP of Avalere Health, a leading advisory company focused on healthcare business strategy and public policy, as they address the opportunities and challenges of reimbursement in the MedTech industry. When we invest in a medtech startup, investors frequently ask about the probability of getting a device approved and reimbursed for in the US.   Join us to learn about: Reimbursement basics: what is coding, coverage and payment? Differences by setting of care: devices to be used inpatient vs devices to be used outpatient Trends in collection of evidence and health economic data ACA (Obamacare) trends relevant for medical device manufacturers

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Page 1: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

How MedTech

Companies Get Paid

Understanding reimbursement basics and how

startups successfully navigate the US medical

system

Page 2: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

Your Hosts

Zack Miller Partner, Investor community

OurCrowd

Fauzea HussainVice President

Avalere Health

Page 3: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

Avalere Health /

2014 Outlook

March 2014

avalerehealth.net

Page 4: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

Avalere Provides A Comprehensive Perspective

Through our engagement with every sector of the healthcare

marketplace, we can support your business goals in an increasingly

integrated and financially-constrained environment.

Page 5: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

Healthcare Reform Increases Covered Lives and Focuses on

Shifting Incentives in Care Delivery

FEE-FOR-SERVICE (FFS) – THE TRADITIONAL APPROACH TO PAYMENT –

VIEWED AS INSUFFICIENT AT CONTAINING COSTS

PAST:

Rewards Volume

FUTURE:

Rewards Quality and

Efficiency

• Siloed FFS

• Volume-based

rewards

• Limited coordination

or shared risk

• Value-based purchasing

• Public reporting

• Bundled payments

• Direct link between

payment and outcomes

• Greater focus on care

coordination and

prevention

Page 6: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

Historical Paradigm

Research & Development Commercial

Development

Commercialization

Inline

PRODUCT LIFE CYCLE

Page 7: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

New Paradigm Required

Development

Commercialization

Inline

PRODUCT LIFE CYCLE

Commercial

Research & Development

Page 8: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

Connect with Avalere

Page 9: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

For more information /Please contact:

Debbie Garner | EMEA Regional Director

[email protected]

+972-54-945-6260

Fauzea Hussain | Vice President Reimbursement and

Product Commercialization

[email protected]

202-207-3802

Page 10: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

’s MedTech portfolio companies

Page 11: How MedTech Companies Get Paid: Understanding Reimbursement Basics and How Startups Successfully Navigate the US Medical System

Zack Miller

OurCrowd

+972-2-636-9000

+1-917-617-1026

[email protected]

www.ourcrowd.com

Fauzea Hussain

Avalere Health

+1-202-207-3802

[email protected]

www.avalerehealth.net

Thanks for joining us!