About Us

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.

Pioneering Healthcare Value for 30+ Years

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.

Leading With Evidence

Creating Value that Drives Demand and Revenue

  • 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.

Creating a Compelling ROI

Setting You Apart and Ahead as a Value-Driver

  • 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.