Case Studies

Proven Medical Device Market Access Case Study Results

Our comprehensive case studies demonstrate how Market Access Experts has helped medical device manufacturers overcome complex reimbursement challenges and achieve sustainable market access for innovative technologies. Each case study provides detailed insights into the specific market access barriers encountered, the strategic approaches developed to address them, and the measurable outcomes achieved through implementation. These real-world examples illustrate our medtech market access consulting services in action, showcasing the tangible value we deliver for clients across diverse therapeutic areas and technology categories.

Cardiac Technology Med Device Market Access Success

One notable case involved a breakthrough cardiac monitoring technology that faced significant coding and payment barriers despite strong clinical evidence supporting its use. Our medical device market access team developed a comprehensive strategy that included successful CPT Category I code applications, Medicare national coverage reconsideration, and targeted economic analyses demonstrating value to commercial payers. This integrated approach resulted in favorable coverage determinations from both Medicare and major commercial insurers, appropriate procedure payment rates, and accelerated provider adoption that significantly expanded patient access to this innovative technology.

Surgical Innovation Market Access Medical Device Strategy

For an emerging surgical technology, we addressed complex challenges related to procedure classification, appropriate facility payment, and physician reimbursement across multiple sites of service. Our market access medical device consultants conducted detailed payment analyses, developed a compelling economic value story, and implemented a strategic plan for securing appropriate coding and payment pathways. These efforts resulted in favorable MS-DRG and APC assignments, new CPT procedure codes with appropriate RVU values, and positive coverage determinations that enabled successful commercialization and widespread clinical adoption.

Diagnostic Technology Market Access Services Breakthrough

When a diagnostic technology company encountered obstacles to payer coverage despite strong clinical validation, our med device market access specialists developed a multifaceted strategy to overcome persistent coverage barriers. This approach included systematic gap analysis of existing evidence, development of a health economic model demonstrating budget impact benefits, engagement with medical societies to secure guideline inclusion, and creation of a payer engagement program featuring key opinion leaders. The resulting expanded coverage determinations dramatically increased test utilization and enabled positive return on the manufacturer's substantial development investment.

Digital Therapeutic Medical Device Market Access Pioneer Solutions

A novel digital therapeutic faced unprecedented challenges in securing reimbursement through traditional medical benefit structures due to its innovative nature and delivery model. Our market access providers developed a pioneering approach that included alternative payment model development, self-insured employer direct contracting, value-based agreement templates, and strategic positioning for emerging digital health CPT codes. This innovative strategy enabled market entry and revenue generation while establishing pathways for broader reimbursement as digital therapeutic payment models continue to evolve.

Home-Use Device Market Access Experts Implementation Success

For a groundbreaking home-use medical device, we addressed complex challenges related to benefit category determination, coding classification, and payment methodology selection. Our market access solutions included successful HCPCS code application, strategic engagement with Medicare pricing authorities, development of a comprehensive economic value story, and creation of model coverage policy language for commercial payer adoption. These efforts resulted in favorable payment determination, broad commercial coverage, and simplified billing processes that facilitated patient access and provider adoption.

About us

At Market Access Experts, we measure our success through the tangible outcomes achieved for our clients – expanded coverage, appropriate payment, accelerated adoption, and ultimately, improved patient access to innovative medical technologies. These case studies represent just a sample of the reimbursement challenges we have successfully navigated, demonstrating our proven ability to overcome complex market access barriers across diverse therapeutic areas and technology categories.

Contact Our Coverage Experts

Reach out for insights on payer coverage analysis and market access strategies for medical devices. We're here to help you navigate challenges.

Connect

480.717.7865

Inquire

info@coverageinsights.com