Helping Clients Lead the Volume-to-Value (V2V) Transition
Coverage, coding, and contracting strategies for drugs, devices, and healthcare delivery methods
If your markets are shifting fee-for-service (FFS) reimbursement toward value-based payment (VBP) models, then we can help.
We ensure your offerings are (1) evidence-based around the hard sciences, social sciences, and data sciences; (2) value-delivering, with superior performance, outcomes, and impacts; and (3) revenue-generating.
We facilitate (1) real-world data (RWD) and real-world evidence (RWE) alliances; (2) value-based contracting (VBC) and outcomes-based compensation (OBC) agreements; and (3) 360-degree impact accountability.
Our analytical, strategic, and support services help you improve market access, market messaging, and market engagement.
This accelerates market acceptance of your healthcare breakthroughs and best practices so you can take your rightful place at the forefront of U.S. healthcare’s volume-to-value (V2V) transition.
Leading the Volume-to-Value (V2V) Transition Since 1988
Since our founding in the late 1980s, Reimbursement IQ has been helping innovators, entrepreneurs, and executives in BioPharma, MedTech, and Healthcare companies gain value-based coverage, coding, compensation, collaborations, and contracts.
We have served pioneering startup ventures, small and mid-sized businesses (SMBs), and brand-name multinational corporations (MNCs); and our client list includes scores of Inc. 5000 and Fortune 500 companies.
We offer scientific, technical, and medical (STM) experts with advanced training in data science, influence analytics, and payment precedent-setting.
We offer marketing communications experts with decades of experience in audience targeting, value proposition development, and content development and syndication.
We offer stakeholder engagement experts who are thought and practice leaders in (1) U.S. healthcare and health plan navigation services; (2) health literacy, plain language, and culturally competent (HL/PL/CC) support services for improved patient self-efficacy; and (3) referral services to community care, healthcare, and self-care resources.
We measure success in terms of (1) more favorable social determinants of health (SDoHs); (2) improved program, provider, and product performance, outcomes, and impacts; and (3) realization of Triple/Quadruple Aim endpoints including reduced per capita costs, enhanced population health, and more positive patient/provider experiences.
To ensure your solutions are evidence-based, we (1) compile and evaluate scientific, technical, and medical (STM) literature; (2) identify and engage the right key opinion leaders (KOLs) and subject matter experts (SMEs); and (3) develop persuasive and empowering content optimized for decision-making audiences (e.g., policymakers, payers, purchasers, providers, and patients).
To ensure your solutions are value-delivering, we (1) measure the incidence, prevalence, and cost of the conditions you address, using insurance claims analytics (where available); (2) pilot-test and then standardize your approach for scalability and salability; and (3) establish achievable and quality-assured guarantees around performance, outcomes, and impacts.
To ensure your solutions are revenue-generating, we (1) characterize and prioritize policymakers, payers, purchasers, providers, and patients for market influence and impact; (2) pilot-test and then standardize persuasive communications to support favorable purchasing, reimbursement, and/or contracting decisions; and (3) measure and continuously improve performance, outcomes, and impacts over time.
Building Performance, Outcomes, and Impact Accountability
Leveraging Data, Transparency, and Real-World Evidence (RWE)
Market leaders know that—to emerge as winners in an increasingly value-focused marketplace—today’s healthcare products, services, and solutions must (1) reduce the incidence, prevalence, and cost of diseases and other adverse health conditions; (2) improve economic, clinical, and humanistic outcomes (ECHOs); and (3) achieve the Triple/Quadruple/Quintuple Aim of reducing per capita costs, improving population health, enhancing the patient/provider experience, and boosting health equity.
Machine learning, artificial intelligence (AI), and other “data science” methods create unprecedented levels of visibility in U.S. healthcare.
Pioneering healthcare policymakers, payers, purchasers, providers, and patients can evaluate what’s driving successful and unsuccessful healthcare interventions.
Insurance claims analytics, human capital analytics, and influence analytics can quickly reveal not only which healthcare interventions work or don’t work clinically, but also who’s funding whom and why.
Network analytics and the Sunshine Act further clarify who’s getting paid by whom for what (e.g., KOL grants for legitimate research purposes versus KOL payments for mercenary market influence).
As results-related accountabilities soar, value-based contracts (VBC) and covered lives (aka volume) go to “good actors” (key outcomes leaders)—while “bad actors” (mercenary KOLs) get disintermediated.
If you’re committed to earning your rightful place at the forefront of your field, then we’re the strategic partners you need.
Count on us to improve (1) market access, by developing HEOR/CER models, securing unique insurance billing codes, and crafting the case for coverage; (2) market messaging, by running messaging analytics, studying messaging trends, and outperforming the competition with high-impact marketing content and communications that set you apart and ahead; and (3) market engagement, by identifying and helping you engage key opinion leaders (KOLs) and subject matter experts (SME) who can ensure your products, services, and solutions are 360-degree impact-accountable.
We’ll help you gain the earnings growth you deserve, given the value you deliver.