Our services

What we do best

Working together

We help healthcare innovators get paid

Deep, foundational market access & reimbursement analyses and assessments form the basis of our actionable strategies for coverage, coding, contracting, reimbursement, pricing, and evidence.

We guide and support early-stage and established diagnostic labs, companion diagnostics, platform companies, medical devices, SaaS, and SaMD.

We also assist organizations making informed Market Access decisions driven by insights derived from our coverage and claims data platform, MA360i.

benefiting scientists

How we work

Engagement Process Overview

Define success

How would you characterize the success of an engagement with NGS Reimbursement Solutions?

Define the needs

What is your motivation for reaching out to consultants?

What are the key assumptions, do they need testing?

What are the known questions you need to answer?

What are possible, until now unasked questions which concern you?

Summarize the Issues

Determine what has already been done to address these issues including the internal and external personnel / resources used to address them

Design the plan

NRS creates a proposal to address the identified needs

Testimonial

“We have some folks who thought they knew Market Access; you have opened everyone’s eyes, thank you!”

Chief Commercial Officer, medical device startup

We've been there

Completed Journeys

Our broader team includes experts in regulatory, lab implementation, billing services evaluation and implementation, and market research.

Helped negotiate a reimbursement rate of ~95% of list price with a MAC

Led a multi-organizational effort to challenge a CMS proposed pricing which led to a ~14-fold increase in the final pricing

Negotiated a risk-based contract with an IDN to develop needed evidence for coverage

Helped to found and chaired several committees of a coalition of labs for expanding coverage of a test by commercial payors and Medicaid

Co-created a training program to help genetic counselors better understand and communicate important reimbursement information to their patients

Led cross-company teams that successfully developed and implemented Evidence Development Strategies that aligned the teams, resources, and priorities

Map critical reimbursement processes

Map will help maintain or accelerate strategic commercialization milestones

Craft investor communications

Build a strong foundational understanding of how your product will be reimbursed

Develop and conduct Market Access / Reimbursement training

Understand where the market is and how to influence it for the best results

Support the creation of an evidence development strategy

Plan to align evidence needs, budgets, and priorities across the organization

Regulatory paths strategy decision support

Develop strategy with implications for Market Access / Reimbursement

Develop and shape value messaging

Speak to payors, laboratory benefit management companies, and Medical Societies in their own language

Develop Medical policy

Consider elements such as National Coverage Decision (NCD) / Local Coverage Decision (LCD) for Medicare and commercial policies

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Understand payors and help them solve their challenges

Payor Market Research Surveys / Interviews / Advisory Boards to develop payor-centric strategies and value messages that resonate with payors

Conduct deep, foundational market access & reimbursement analyses and assessments

Asessments will form the basis of actionable strategies for coverage, coding, contracting, reimbursement, pricing, and evidence

Create market access, reimbursement & payor collateral

On brand visuals for internal and field-based personnel

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Testimonial

“Wish we had called you earlier in the process!”

CEO, early-stage AI start-up

Testimonial

“Wish we had called you earlier in the process!”

CEO, early-stage AI start-up