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Medicare Bonus Payments: CMS Plans To End Three, But Considers Seven New-Tech Add-On Payments For FY 2019
While the US Medicare agency is proposing to end hospital inpatient new-technology add-on payments for Edwards Lifesciences’ and LivaNova’s minimally surgical valves, and for WL Gore's endoprosthesis aneurysm device, it is evaluating possible bonus payments for 7 more devices beginning Oct. 1.
Latest From Market Access
Electrophysiologists are running into challenges in getting subcutanous ICDs covered by private insurers. See why consultant and former Aetna executive Jim Cross thinks that could change this year based on recently updated guidelines.
Despite many electrophysiologists' enthusiasm for less-invasive cardiac rhythm management devices, insurers are frequently denying coverage of Boston Scientific's Emblem subcutaneous implantable cardioverter defibrillator (S-ICD) for patients, citing what they argue is a lack of adequate clinical data that shows them to be better than "experimental." Boston Scientific recently sponsored a virtual roundtable of physicians to discuss how new professional society guidelines are influencing prescribing and reimbursement of these devices.
Medtech Buyers Care Most About Positive Patient Outcomes, Durability When Assessing Products, Survey Finds
Attributes that best differentiate medical devices in a competitive market are: low risk, those that work well for the task demanded, consistent outcomes, good patient outcomes, and proven and trusted brands, according to a survey by marketing analytics firm Vennli. Device manufacturers must be willing to make changes in marketing messages to stand out from the competition, the firm says.
Orthopedic surgeons never favored mandatory bundled-payment programs such as the Comprehensive Care for Joint Replacement model. In fact, in comments to CMS, surgeons requested that the US Center for Medicare and Medicaid Innovation make the programs voluntary and scale them back.
South Africa's medtech industry has much to look forward to, given the emergence of the new South African Health Products Regulatory Authority (SAHPRA) and the sheer volume of activity in recent years dedicated to establishing the mechanisms to secure fully regulated, safe and high-quality medical devices. But it's not the end of the road; there remain some tricky stretches ahead, including new "pricing" regulations, as discussed at the 2018 MedTech Forum.
South Africa is like no other country, having emerged through difficult decades of social inequality to now be embracing, among other things, modern health-care delivery via new regulatory structures, a national development plan and a National Health Insurance program (NHI). It is a potentially lucrative opportunity, but medtech players need to be wise to particular localization needs when embracing the South African market.
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