This title is printed to order. This book may have been self-published. If so, we cannot guarantee the quality of the content. In the main most books will have gone through the editing process however some may not. We therefore suggest that you be aware of this before ordering this book. If in doubt check either the author or publisher’s details as we are unable to accept any returns unless they are faulty. Please contact us if you have any questions.
The odds that a healthcare startup will fail is 90%, and 20% of new businesses fold by just one year in. Not clearly understanding who will pay for the product and how much of the reimbursement is a deadly and easy mistake to make.
Every day, doctors and patients face difficult choices. Should a patient with stable chest pain undergo a surgical procedure, even though studies show that most patients do not benefit from procedures like coronary artery bypass graft or coronary angioplasty? And should a breast cancer patient with ductal carcinoma in situ receive radiation therapy after surgical excision to prevent recurrences that occur in 20-30% of women over 10 years? Medical innovations, such as those discussed in the book, offer better diagnosis and treatment options for patients in need.
However, for a medical innovation to reach patient care, it must typically be paid for. Healthcare reimbursement is the complicated and intertwined process by which a medical innovation receives payment. Healthcare reimbursement is a critical product-to-market question for entrepreneurs and venture capitalists, as the answers decide the likelihood of building a sustainable and successful business from a medical innovation.
The healthcare reimbursement ecosystem exerts powerful forces that shape an innovation's adoption and diffusion in patient care. This book provides a detailed account of the US ecosystem regulating market access to medical innovations. Specifically, in the "Healthcare's Reimbursement Maze" you will discover:
Why medical coding is crucial to reimbursement
How the payment systems are designed, evolved, and adapted to new technologies
How public programs and private health plans decide whether to cover a new technology
The roles of healthcare providers in the reimbursement ecosystem
Strategies for navigating the maze of reimbursement
