Promoting Healthcare Breakthroughs, Best Practices, and Benchmarks

Improving Client Performance, Outcomes, and Impacts

  • Reimbursement IQ specializes in coding, coverage, compensation, collaboration, and contracting strategies for lifesaving drugs, devices, and healthcare delivery methods. 
  • Our analytical, strategic, and hands-on support services help BioPharma, MedTech, and other Healthcare-related clients generate, promote, and sustain superior economic, clinical, and humanistic outcomes (ECHOs) in an era of value-based healthcare (VBHC).
  • With real-world evidence (RWE) of superior value, our clients enjoy broader market access, more compelling market messaging, and deeper market engagement (e.g., honorable relationships with ethically grounded key opinion leaders [KOLs]).
  • This leads to improved client revenues, earnings growth, and competitiveness.
  • And it helps the best drugs, devices, and healthcare delivery methods take their rightful place at the forefront of the U.S. healthcare industry.

Leading the V2V Transition

Compiling Real-World Data (RWD) and Real-World Evidence (RWE)

  • Our clients become 360-degree accountable for real-world results—building real-world evidence  (RWE) for outcomes-based compensation (OBC) under U.S. Healthcare’s volume-to-value transition (V2V).
  • In true value-based healthcare, payment ties to product, service, and solution performance, outcomes, and impacts.
  • Reimbursement IQ helps chief officers, senior executives, and their work teams retool for the volume-to-value (V2V) transition and value-based healthcare (VBHC).
  • We offer analytics, strategy, and support services to improve (1) market access, (2) market messaging, and (3) market engagement.
  • With our help, the C-Suite, department heads, and knowledge workers navigate the market transition from fee-for-service (FFS) reimbursement to real-world data (RWD) and real-world evidence (RWE) alliances, value-based contracting (VBC) and outcomes-based compensation (OBC) agreements, and 360-degree impact accountability.

Collecting RWD and Building RWE Through Hub Services

Creating Living Labs in the Form of Next-Gen Access, Hub, and Wraparound Services

  • With our help, CxOs, senior executives, and their teams are prepared to lead the market preemptively under fee-for-service (FFS) payment systems and emerging value-based healthcare (VBHC) models.
  • We help these pioneering clients to (1) improve patient engagement, activation, and adherence using next-generation hubs  (e.g., access, hub, and wraparound solutions) to deliver health plan navigation services, Plain Language support services (for health literacy), and community care referral services (to social services programs focused on social determinants of health [SDOHs]); (2) leverage hub services to capture real-world data (RWD) and build real-world evidence (RWE) of value for healthcare policymakers, health plan purchasers, third-party payers (TPPs), third-party administrators (TPAs), healthcare provider organizations, healthcare professionals (HCPs), and patients; and (3) secure access to millions of covered lives, providing performance, outcomes, and impact guarantees under value-based contracting (VBC) and outcomes-based compensation (OBC) models.
  • We’re a critical go-to resource for chief officers, senior executives, and top teams grappling with U.S. healthcare’s volume-to-value (V2V) transition and how to secure real-world data (RWD) and (RWE) in an era of value-based contracting (VBC) and outcomes-based compensation (OBC). 
  • Count on us for volume-to-value (V2V) transition and value-based healthcare (VBHC) support in Medical Affairs Departments, HEOR/Value Units, Market Access Departments, Commercial Units, and Real-World Alliance Units.

Differentiating Between Volume and Value

Wielding Social Responsibility as a Gold-Standard Practice

  • Though mission-driven, we’re highly practical: “No margin, no mission!”
  • And we’re partial to serving enlightened leaders and work teams who understand the need for both earnings growth and social benefit.
  • Our clients are rare and forward-thinking innovators, entrepreneurs, and executives. They know social responsibility is a best practice in life and in the business of healthcare. They also know the degree of transparency that data science creates…and how extreme transparency translates to unprecedented clinical, financial, and legal accountability. 
  • Whether conscious capitalists or simply servant leaders and good stewards, they have long held themselves accountable to endpoints beyond increasing shareholder value.
  • With our analytics, strategy, and support services, they can (1) increase revenue, operating efficiencies, earnings growth, competitiveness, and compliance (to exceed the demands investors); (2) reduce the incidence, prevalence, and cost of diseases and other adverse health conditions; (3) improve economic, clinical, and humanistic outcomes (ECHOs); (4) achieve Triple/Quadruple/Quintuple Aim endpoints (of reduced per capita costs, improved population health, enhanced patient/provider experiences, and boosted health equity); (5) enhance the wellbeing, productive capacity, and socioeconomic status of individuals, organizations, and communities; (6) enable sustainable and increasingly broad-based human flourishing, contributions, and socioeconomic lift in alignment with the United Nations’ Sustainable Development Goals (e.g., SDG #3: Health); and (7) contribute to a better functioning global society.

Leading the Field for Three Decades

Building Gold-Standard Services Around Value

  • Founded in 1988—and operating under a formal Credo in collaboration with our longstanding strategic partners at Central IQ—Reimbursement IQ has more than three decades of experience (1) ensuring clients’ product portfolios are category-creating and positioning clients for fast-growth, superior earnings, and preemptive market leadership; (2) securing favorable coverage, coding, and reimbursement decisions under fee-for-service payment systems; and (3) outperforming the competition under value-based contracts (VBC) by boldly tying payment to performance, outcomes, and impacts.
  • We pioneered real-world data/evidence (RWD/RWE) collaborations, value-based contracting (VBC) and outcomes-based compensation (OBC) for new product, service, and solution categories as far back as the late 1980s and early 1990s.
  • We built and still build predictable, defensible, and society-upholding revenue streams for (1) innovative healthcare providers (like biologics-focused home healthcare companies), (2) groundbreaking medical devices (like implantable insulin pumps), and (3) breakthrough biopharmaceuticals (like Adagen [pegademase bovine] for Bubble Boy disease (severe combined immunodeficiency disease [SCID] associated with adenosine deaminase deficiencies).
  • We understand (1) how to find progressive payers, health plan sponsors (e.g., self-insured employers, unions), and capitated providers; (2) what’s compelling to them that earns their support quickly and legitimately; and (3) how to win favorable and well-deserved real-world data/evidence (RWD/RWE) agreements, value-based contracts (VBCs), and outcomes-based compensation (OBC) by accepting 360-degree accountability for real-world results (RWRs) at the level of individuals, organizations, and communities.

Delivering Analytics, Strategy, and Support Services

Improving Market Access, Market Messaging, and Market Engagement

  • Count on Reimbursement IQ to prove your healthcare products, services, and solutions warrant favorable policy, coverage, coding, reimbursement, contracting, and payment decisions.
  • We’ll help you (1) attract proof-of-concept partners to secure market access, patient access, and data access; (2) compile real-world data (RWD) and real-world evidence (RWE) of the Triple/Quadruple/Quintuple Aim and other critical real-world results (RWR); and (3) demonstrate you’re the uncontested value leader in all your markets.