- Custom Market Research and Analytics on the reimbursement landscape and specific concerns likely to affect your product, product line or development-stage opportunities.
- Rapid Response provides a real-time “pulse” with a panel of managed markets experts to obtain critical information for brand decision making and pipeline strategy.
- Syndicated Reports reporting the insights from payers on their evolving thinking about the latest scientific developments in key therapeutic areas in order to understand how they’re likely to respond with access and cost controls to the newest therapies.
- Training Programs for management and sales forces so they understand the reimbursement issues physicians and managed care executives care about most.
- Managed Markets Communication – delivering the right messages about your products so that payers can understand its innovations and make it accessible to physicians and patients.
Many plans include an “expert” physician (the P&T Advisor™), who is an ad hoc consultant to P&T Committees or serves as an informal medical advisor for a specific therapeutic area.
Why are P&T Advisors™ Important?
RI’s P&T Advisors™ may:
- Influence plans representing millions of covered lives
- Refine your Managed Markets strategic plan based on formulary updates
- Proactively prepare for and respond to future formulary reviews
- Serve as panel contracted for scheduled quarterly use
Who are these P&T Advisors™?
P&T Advisors™ are difficult to identify, but are extremely influential as brand advocates or opponents. RI has learned that insiders aren’t always “called on” physicians or KOLs; many times they are local practice physicians familiar with the plan. Insiders may not be high prescribers of the drug or even practice medicine in the same field as the product they are reviewing.
RI’s P&T Advisor™ panel is comprised of identified and profiled physicians. Our proprietary identification process validates their scope of influence from both the payers’ and the insiders’ perspectives to clarify their role and importance to the health plan, including:
- Type and frequency as advisors to health plans
- Prescribing habits
- Scope of influence by covered lives/plan
P&T Advisor™ provides feedback and guidance for critical initiatives throughout the life of your brand.
- Prepare for formulary reviews at targeted health plans
- Plan for clinical and health outcomes “must haves”
- Develop effective Managed Markets “value” proposition
- Finalize pricing and contracting strategies
- Identify differences between payer and P&T
- Insider reviews of Target Product Profiles (TPP)
- Gauge response to negative or disadvantaged formulary position
- Gain competitive intelligence
- Protect from threat of generic or new market entrants
- Engage P&T Advisors™ in ongoing research and advisory board activities to build advocacy
- Evaluation of Managed Markets and brand promotional materials
- Develop or identify additional candidates for KOL or managed care speaker bureaus
Rapid Response Service
RAPID Response is a quick turnaround research service that delivers critical intelligence for brand decision-making and pipeline strategy
- Surveys access targeted managed markets experts to ensure you reach the customer segments critical to your research objectives
- Quantitative and qualitative survey designs are offered at two levels
RAPID Response offers flexible access options
Let RAPID Response help you quickly translate market insights into actionable results.
Reimbursement Intelligence Network (RIN)
It’s not a product. And it’s not a service. But the Reimbursement Intelligence Network, or RIN, underlies much of the work we do – and keeps making us smarter about the world of managed markets. RIN is an extensively coded database of over 5,000 key decision makers in government and commercial health plans, integrated delivery systems, accountable care organizations (ACOs) and pharmacy benefit management companies. We’ve got all the people who directly make the formulary decisions – pharmacy directors, medical directors, but we’ve also got the people who are important influencers on access decisions, including office billing managers, hospital chief operating officers, quality improvement directors and case managers, employers and employee benefit consultants. We survey them regularly on behalf of our clients – and for ourselves. And because we talk to them so regularly, we’ve also learned how to talk to them: we know the right questions to ask to elicit actionable information, to get our clients closest to the truth about reimbursement, to what will happen to their product in the marketplace. And we also know which members of our RIN to talk with about your specific program: since the database is extensively coded, we can virtually instantly target the right RIN members. If your product is likely to be heavily used in a Medicaid population, for example, we’ll make sure we’re talking with RIN members who influence access in Medicaid – and that we’re not wasting your time (and coming up with misleading information) by surveying RIN members with no influence in that segment of the payer community.
The RI analytics team will focus on identifying the reimbursement landscape for the product or technology by speaking with members of the RIN, Reimbursement Intelligence Network. The RIN represents Managed Care experts from Medicare, Medicaid, and Commercial plans. We have the pulse of the market and have several unique services unparalleled in the industry. We have a database of more than 5,000 decision makers and can segment them based upon customer type, number of covered lives, demographics, or any other customized request.
Reimbursement RiQ Training
Maximize sales force reimbursement effectiveness
Our changing reimbursement landscape is demanding greater attention, with economics playing an increasing role in provider decision-making. Training on reimbursement issues is now a critical component for a sales force to remain effective in our value-driven healthcare marketplace.
Equip your Sales Force
Knowledge – Ensure your representative demonstrate understanding of the current and future reimbursement landscape, and respond appropriately to customer questions
Messaging – Deliver consistent and on-message information about reimbursement and access
Assistance – Act as liaison for providers and staff when implementing your own reimbursement assistance program
Resources – Become a go-to resource for providers and staff on reimbursement and access issues
Our Approach to Reimbursement Training
At Reimbursement Intelligence (RI), we take an integrated approach to reimbursement training. Working with your existing sales program, we can provide add-on training components or, when needed, build a program from the ground up. Each ensures our clients have targeted reimbursement tools for their specific needs. General information categories our clients often look for include:
- Drug Distribution
- Patient Assistance Programs
- Reimbursement in government programs
- Managed Care Basics
- Billing and Coding
Dynamic Training Vehicles
Our capabilities at RI include the latest technology platforms as well as more traditional training vehicles, including:
- iPad apps
- Live Workshops
- e-learning Training Guides
- Train-the-Trainers Programs
Managed Markets Communications
Reimbursement Intelligence (RI) partners with our clients to deliver customer communications that inform, motivate, and integrate with provider and patient messaging platforms.
Full Service Communications Capabilities
RI offers full service customer communications with our team of writers and designers focused in the managed markets area. Our capabilities include traditional print as well as the latest digital technologies to increase customer participation and engagement, such as iPad tools and interactive video.
Recent customer fulfillments include:
- Branded and unbranded slide presentations
- Product Value Propositions
- Health Economics Outcomes Research (HEOR)
- Disease Management
- Clinical monographs
- White papers (Impact of Medicare Part D, Value-based Insurance Design)
- E-print carriers
Managed Markets Research and Analytics
Reimbursement Intelligence (RI) supports its clients through customized research and development of targeted reimbursement strategies across a product’s life cycle.
Recent custom research topics include:
- Value Proposition Messaging and Positioning
- Health Outcomes Research
- Employer Coverage Decision Making
- Customer Segmentation Research
- Pricing and Contracting
From early development through commercialization, RI helps clients identify critical challenges and opportunities in today’s managed markets environment.
Download may take a few minutes.
Chief Executive Officer
Norman C. Selby is CEO of Reimbursement Intelligence and has been active in the healthcare world for over 30 years in a variety of operating, investment, consulting, and Board roles. In addition to his role as CEO, he is also serving as Executive Chairman of Real Endpoints llc., an innovative healthcare information business focused on the changing US reimbursement landscape.
Mr. Selby is also on the Board of three healthcare product companies: Infinity Pharmaceuticals, a leading public (INFI) oncology biotech company, Metamark Genetics, a start-up oncology diagnostics company, and Merz Group GmbH, a global specialty pharma company based in Frankfurt, Germany. He has previously served on the Boards of Millennium Pharmaceuticals (MLNM) and several other private healthcare companies.
During the past decade Mr. Selby led the growth and development of three healthcare companies, all of which had successful exits to larger strategic enterprises: Physicians Interactive Inc, which he built as Executive Chairman through 4 acquisitions from 2008 – 2012, and sold in 2013 to Merck GHIF; Windhover Information, which he invested in and became Executive Chairman of in 2004, and which was acquired by Reed Elsevier in 2008; and TransForm Pharmaceuticals, where he was CEO and President from 2001 – 2004, and which was acquired by Johnson & Johnson.
Mr. Selby spent the bulk of his career (1978 – 1997) at McKinsey & Company where he was Director (Senior Partner) in the firm’s New York office. He held several leadership roles at McKinsey, including head of the firm’s Global Pharmaceuticals and Medical Products Practice. From 1987-1989, Mr. Selby took a leave of absence from McKinsey to serve as Chief Operating Officer of the New York Blood Center, the largest community blood organization in the country, where he led its financial and operational turnaround. After McKinsey he went to Citicorp/Citigroup where he was an Executive Vice President.
Mr. Selby serves on the Board of Trustees of the Central Park Conservancy, the Memorial Sloan-Kettering Cancer Center and the Ralph Lauren Center for Cancer Care and Prevention, all based in New York City. He is also a member of the advisory board of the Harvard Business School’s Healthcare Initiative, and a Board member of the National Parks Conservation Association in Washington D.C.
Mr. Selby holds a B.A. in Architecture from Yale College and an M.B.A. with Distinction from the Harvard Graduate School of Business Administration.
John Hennessy is Vice President, operations for the Midwest Oncology Division of Sarah Cannon, the global cancer enterprise of Hospital Corporation of America (HCA). His focus areas at Sarah Cannon are medical oncology, survivorship, and palliative care.
Mr. Hennessy has held several leadership positions in oncology for more than a dozen years, including his role as the executive director of the Kansas City Cancer Center. Through this leadership, he has led the adoption and implementation of cancer care pathways, in addition to other innovative programs. Having served in the health care industry for more than 25 years, he has experience in physician practice, hospitals, and managed care and health plans. Hennessy received his Bachelor of Arts in English from Colorado College, and a Master in Business Administration degree from the Fuqua School of Business at Duke University.
He serves on the Board of Trustees of the Association of Community Cancer Centers (ACCC), and on several committees for the American Society for Clinical Oncology (ASCO), including the Clinical Practice Committee. Hennessy has been a speaker in the oncology field for many years including ASCO, ACCC, Society for Gynecologic Oncology, Medical Group Management Association, and a number of state and local healthcare meetings from Boston to Hawaii.
John Whang is a board-certified cardiologist with experience in both clinical and corporate environments. Prior to joining RI as COO, John was a senior consultant at McKinsey&Company in its Health Care Practice. He led and conducted multiple studies with pharmaceutical, medical device, payor, and provider clients; he also led due diligences on behalf of private equity and venture capital firms in their assessment of potential targets. While at McKinsey, John established McKinsey’s first Advisory Board of world KOLs in cardiovascular diseases that equipped them with resources to offer as an additional competency to raise its profile of unique consulting services.
Before McKinsey, John was Director of Non-Invasive Cardiovascular Services at Morristown Medical Center in Morristown, NJ, which is the second largest cardiac program in the Northeast. John managed all aspects of inpatient and outpatient cardiovascular services while actively practicing cardiology. He led the introduction of cutting-edge technologies such as intra-cardiac echo (ICE) to enable the growth of innovative catheter-based programs including PFO closure and transcatheter valve.
John received his MD from the College of Physicians and Surgeons, Columbia University and an AB in evolutionary biology from Harvard College.
5 Truths About Oncology Pathways You Need to Know Today
Go “behind-the-scenes” to learn how pathways are created
Guest Speaker: John Hennessy, Vice President, Sarah Cannon
John Whang, MD, FACC, COO, President of Market Research, Reimbursement Intelligence
Date: November 12, 2013
Time: 12:00 pm – 1:00 pm ET
Download the presentation
Oncology pathways are the new formulary. As a major developer and marketer of oncolytics, your decision-making teams need to be aware of the increasing importance of clinical pathways in product selection and use in today’s rapidly changing oncology marketplace.
By learning the key truths about oncology pathways, you will make sure your 2014 planning accurately defines the risks and opportunities associated with your product or portfolio. John Hennessy, an oncology operations expert from Sarah Cannon, will answer key questions and dispel some of the myths about pathways that have arisen as a result of incomplete or wrong information circulating in the industry.
John Hennessy, who has been active in the development and implementation of oncology pathways, will explain exactly how traditional treatment guidelines have evolved into detailed, evidence-based protocols for delivering care to individual patients.
You will walk away from this webinar with a deeper understanding around:
- What clinical factors drive pathway development – Quality? Outcomes? Clinical variation?
- Which market conditions influence pathway development – Treatment costs? Physician compensation? Disease prevalence? Health information technology? Growth of competitive product choices?
- What types of clinical evidence do clinicians evaluate when developing pathways?
- How do benefit designs, formularies, and reimbursement variables impact pathway development?
- Is there evidence that observance of pathway protocols enhances outcomes? Reduces total treatment costs?
- How can your company support pathway development in appropriate cancers?
- Who are the real pathway decision-makers?
Who Should Attend
Anyone who has any stake in the current oncology market or in future development cannot afford to miss this webinar. This includes:
- Brand Managers
- Account Managers
- Sales Leadership
- R&D Teams
- Managed Markets
- Sales Leadership
- Analytics and Market Research
- Corporate Leadership
Don’t miss this landmark educational webinar!
Vice President, New Business Development
Theresa Penyak joins Reimbursement Intelligence (RI) as Vice President, New Business Development, with experience in the healthcare industry focused mainly on managed markets. Prior to joining RI, Theresa was Vice President, Sales with Managed Markets Insights and Technologies (MMIT). In that position, Theresa worked with clients consultatively to integrate formulary data into internal applications, as well as deploy the data to both internal and external customers in innovative formats. Prior to MMIT, Theresa worked at Scott-Levin selling syndicated data and services. Theresa began her career at Sanofi Winthrop where she was promoted several times within the company in the Sales Administration and Pricing Strategy divisions. Theresa holds an MBA from Monmouth University, along with a BA from Fordham University, with a major in Communications and a minor in Psychology.
Pathway Tracker™ – A unique research tool that explains how your key customers design and utilize oncology pathways
A customized tool that provides real-world insights
Pathway Tracker, developed by Reimbursement Intelligence in collaboration with the Cancer Center Business Summit (CCBS), provides you with an exclusive database that delivers insights into real-world pathway management.
With this data available, Pathway Tracker will help you answer critical real-world questions, such as:
- What are the key decision-making parameters in this customer segment for this tumor type?
- What economic and clinical data do providers aggregate or analyze in relation to pathways?
- How do your company’s key customers manage and report on pathways?
. . .and many, many other data-related questions that are likely to shape your customer planning and profiling.
How it works . . .
Pathway Tracker features a two-phase primary research process:
- Phase 1 provides a comprehensive market evaluation on current pathway penetration by customer segment across your entire customer base
- Phase 2 – the customized piece of the research – identifies specific data-driven factors that will help you identify specific risks related to your company’s products
Surveyed customer base
Data profiling is already under way and researchers are conducting interviews with more than 50 institutional and practice-based clinical professionals at the following sites:
- Regional health systems
- Integrated delivery networks
- Academic medical centers
- Community practices
- Private practices
Because the data covers all of these customer segments, you’ll be able to develop customer profiles across the entire market as well as for individual customer segments.
The Bottom Line
The impact of pathways on your brand will go a long way toward determining overall utilization potential for any targeted tumor type oncolytic.
With Pathway Tracker you have access to customer thinking and rationale behind product positioning in the pathways and protocols that directly impact your products.
Find out more right now.