ARTICLES BY EDWARD BLACK
New CMS Payment Rates for 2018; Same Challenges for Medtech8/21/2017
On Aug. 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment and polices when patients are discharged from hospitals from Oct. 1, 2017, to Sept. 30, 2018.
Is Your Device An Attractive Value-Based Purchasing Option?6/19/2017
Traditional Medicare payment to the nation’s 3,500 hospitals is undergoing an historic transition with the Value-Based Purchasing (VBP) Program. The program is not about negotiating price discounts, but rather attempts to address quality while still promoting healthcare cost controls.
MACRA, Non-Adherence Shaping Medtech Reimbursement — For Now3/29/2017
The Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act of 2015 established the Quality Payment Model, starting this year. MACRA has been touted as a guide for leading the development of new devices, but can it survive patient non-adherence, spurred by better access to information, and the proposed American Health Care Act?
Fixing Payment System Will Improve Access To Healthcare3/23/2017
To people who have understood the United States' healthcare payment dynamic, last week's news from the Mayo Clinic is not shocking. However, it is revealing, and the financing conditions that prompted Mayo’s decision must be factored into Obamacare, Trumpcare, or NextPresidentCare.
Digital Health, Connected Health, mHealth – What Are They, And Who Pays For Them?2/2/2017
Government and private insurance health plans struggle for clarity when writing contracts for their members’ healthcare coverage. In each state, these contracts have to be filed and approved by the state departments of insurance and commerce. Is it any wonder there is a need for simplicity, clarity, and consistency in the services each state and private insurer covers?
How Reimbursement-Savvy Sales Personnel Increase A Company’s Bottom Line12/6/2016
This article presents the role of sales personnel in implementing a successful reimbursement plan, and discusses the sales force’s need to understand reimbursement sufficiently to be a resource for their customers.
Value Analysis Briefs – Presenting Your Technology In Its Best Light10/17/2016
A VAB presents the results of a systematic review delineating the potential clinical and economic benefits of a technology, product, procedure or service. It is created with the end user in mind, as there may be multiple stakeholders for whom the value of a technology may differ.
How Device Manufacturers Can Evolve Alongside The Shifting Provider And Payer Landscape9/7/2016
Historically, fee-for-service arrangements allowed hospital facilities to bill costs and receive payments under various contracted reimbursement scenarios, like diagnosis-related groups (DRGs) or fee schedules that transferred most of the risk to the payer. Now, as value-based reimbursement becomes a more pervasive reimbursement mechanism, every care component cost (from paper clips and medical personnel to drugs and devices) is a target for cost management.
The Impact Of Health Technology Assessments On Reimbursement8/8/2016
Within the medical device industry, companies may use HTAs to focus on future product development, and investors may look at HTAs to guide funding decisions for promising innovations. This article will define HTAs and examine how they performed, by whom, and the implications for reimbursement and coverage.
How Medtech Can Benefit From Health Economic Analyses And Cost Effectiveness Data7/7/2016
A health economics analysis examines the balance between a technology’s additional health benefits and the costs associated with achieving those benefits. The HEA helps to answer the question “is it worth it?” Here, we review the different types of analyses, discuss when to use each, and examine a payer’s perspective on health economic analyses.