In
its recent coverage of the MDMA Reimbursement Conference,
Medical Device Daily featured insights from JR Associates
President, Judy Rosenbloom. She was one of three expert
panelists who discussed the changing landscape surrounding
reimbursement policy – and the increasing influence
of specialty societies in that mix.
According
to Rosenbloom, private insurers are moving aggressively
toward pay-for-performance programs. They’re
also seeking deeper information about medical necessity
and provider qualifications – which translates
into increased demand for accreditation.
“We
keep going to CMS and getting more accurate payment
systems” with increased clarity and transparency,
she noted. But private payers “are taking control
by hiring benefit management companies to either
establish clinical guidelines, or they’re turning
to experts who decide whether a beneficiary gets
a device.”
Private
payers are increasingly “partnering with the
specialty societies” and their coverage policies
are becoming more stringent, Rosenbloom said. “Appropriateness
for device reimbursement is all driven by evidence-based
guidelines,” and specialty societies are playing
an increasingly central role.
Other
participants in the panel included Jo Ellen Slurzberg
of Almryra, and John McInnes, MD, a partner at the
law firm of Arnold & Porter.
MEDICAL
DEVICE DAILY
MDMA Reimbursement Conference Coverage
Panel: Specialty Society ‘Sway’ on Reimbursement
is Growing
November 16, 2007
Vol. 11, No. 209
To
read the full article, visit Medical Device Daily
on the web at
http://www.medicaldevicedaily.com/.
