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Reimbursement for Medical Technology

Wednesday, April 11, 10:30-12:00
Ski-U-Mah, McNamara Alumni Center

Organizers: Gregory Peterson, Innovation Collaborations Director, Earl E. Bakken Medical Devices Center, University of Minnesota

"Learn About Reimbursement Language and Processes"
Paula Davis, Regional Director of Health Economics and Reimbursement (HE&R), Abbott

"Market Launch Time – Securing Coverage for Med Devices"
Kathy Sherwood, Vice President, Global Market Access, Inspire Medical Systems

"In a Value Driven Healthcare Environment, How Data and Analytics are Driving Payers and Provider"
Steve Clark, Senior Vice President and Chief Strategy Officer, Optum Life Sciences


Session Abstract:

In this session learn the basics about the language of reimbursement: coverage, coding, and payment. Further, understand the importance of timing when addressing coverage and payment (e.g. well before product launch). We will explore that timing, the questions to ask both internally and externally, today’s coverage processes that must be addressed, and the relationship of data and value to coverage decisions. We will further explore the new environment that includes data as a key component of value in an era of valued-based payment. Gone are the days of having a network of medical directors to rely on to get coverage—our industry has moved into data and outcomes as defining factors. Whether yours is a new and revolutionary product or an improvement/evolutionary product, there are pathways to consider. Hear from experienced market access and payer data professionals from medical device firms and Optum.


Session Organizer Bios:

Gregory "Greg" Peterson, Innovation Collaborations Director, Medical Devices Center, University of Minnesota
"Greg" Peterson is a medical devices and healthcare services business development professional with more than 40 years of successful leadership experiences as intrapreneur, entrepreneur and corporate executive. His competencies include working with early stage technology development from product ideation to commercialization. Greg has co-founded several companies, and is experienced with start-up operations, strategic planning, manufacturing, marketing, sales and strategic alliance structuring.


Speaker Bios:

LotanPaula Davis, Regional Director of Health Economics and Reimbursement (HE&R), Abbott
Paula is a regional director of Health Economics and Reimbursement (HE&R) at Abbott (formerly St. Jude Medical). In this role, she supports all Abbott businesses and is currently on a special project focusing on the Neuromodulation business unit. Prior to joining Abbott, she was at Medtronic for 11 years in HE&R roles supporting Coronary/Aortic/Peripheral/Vascular businesses as well as Neuromodulation therapies. She is responsible for financial analyses, customer and internal training, HCP economic consultations, and strategic business development.

Before focusing on HE&R work, Paula spent over 15 years in operational and leadership roles in major payer systems (BCBS of MN and UnitedHealthCare).

She holds an MBA from the University of Saint Thomas, St. Paul, MN; a Bachelor’s degree from Saint Olaf College, Northfield, MN; and a Certified Professional Coder (CPC) designation.

LotanKathy Sherwood, Vice President, Global Market Access, Inspire Medical Systems
Kathy joined the medical device industry in 1992 as a process engineer in the cardiac rhythm management sector. She spent 12 years working for the Guidant Corporation in R&D, Sales, Marketing, and Business Development. She transitioned into Pricing, Reimbursement and Market Access for several medical device companies. She ran global pricing for Medtronic CRDM, European Health Economics & Reimbursement for KCI Medical, was VP of Strategic Marketing for St. Jude Medical, and lead global Market Access for American Medical Systems. Kathy is now leading Reimbursement and Market Access for Inspire Medical Systems, who manufactures and distributes a Hypoglossal Nerve Stimulation device for treatment of Obstructive Sleep Apnea.

Kathy and her family relocated to the Netherlands for 3 years in 2009, where she led a pan-European Health Econ. & Reimbursement team. In this role, she developed an intimate working knowledge of European health systems and the requirements for gaining reimbursement, obtaining positive guidelines, and managing Health Technology Assessments. She has strong relationships with several European health authorities, and a deep understanding of the clinical and economic evidence requirements for building markets in the US and across Europe.

Kathy holds a Bachelor of Science degree in Mechanical-Industrial Engineering from the University of Illinois, Urbana-Champaign, and an MBA from the University of Minnesota, Carlson School of Business in Minneapolis.

Steve Clark, Senior Vice President and Chief Strategy Officer, Optum Life Sciences
Mr. Steve Clark, previously of the Lewin Group, has more than 20 years of experience in the medical device field with extensive experience helping pharmaceutical and medical device companies in marketing, clinical and reimbursement areas. Mr. Clark has worked with numerous early stage technologies to assess reimbursement issues and develop strategies to assess market differentiation opportunities. This work has included stakeholder analysis for payor, health policy and clinicians and horizon scanning assessments for market opportunity and comparative analysis. He has been responsible for helping clients develop clinical strategies for treatments to obtain market differentiation and ultimately obtain positive coverage; supported clients to develop clinical and cost outcomes to support the benefits of their products; and developed successful pricing strategies. He has experience in the medical technology realm, specifically in the orthopedic, endocrinology, GI, urology, general surgery, colorectal, pathology and gynecology fields to address comparative value issues related to price value equations and support of client product differentiation. He has worn many hats while supporting small- and medium-sized medical device, pharmaceutical, and biotechnology companies. With his background in policy coverage issues and applications, and his previous experiencing in managing reimbursement and interactions with the key stakeholders, He routinely provides strategic management on projects, manages the project process, and plays a key role in supporting clients’ needs.


Presentation Abstracts:

"Learn About Reimbursement Language and Processes"
In this session learn the basics about the language of reimbursement: coverage, coding, and payment. Further, understand the importance of timing when addressing coverage and payment (e.g. well before product launch). We will explore that timing, the questions to ask both internally and externally, today’s coverage processes that must be addressed, and the relationship of data and value to coverage decisions. We will further explore the new environment that includes data as a key component of value in an era of valued-based payment. Gone are the days of having a network of medical directors to rely on to get coverage—our industry has moved into data and outcomes as defining factors. Whether yours is a new and revolutionary product or an improvement/evolutionary product, there are pathways to consider. Hear from experienced market access and payer data professionals from medical device firms and Optum.

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