Policy Analysis
Review of payer policies to identify impact on client portfolios
WHAT WE DO...
- Define key business need(s)
- Understand payer policy landscape, including commercial payers, Medicare & Medicaid
- Develop a policy framework to identify risks and opportunities for key assets
- Ensure alignment with client needs and priorities
WHAT TO EXPECT...
- An evaluation of how key assets fit into current policy framework
- Analysis of gaps in current policy environment
- Workplan to close gaps in manner consistent with client goals and priorities
- Development of collateral supporting advocacy efforts with payers
Case Study #2
THE SITUATION
GHC was engaged by a developer of a novel ophthalmic product to identify changes in reimbursement trends
THE ASK
The client wanted to understand if payers were currently covering, or were likely to cover their product
PAYER TREND REVIEW
• Inventoried commercial payer and state Medicaid program policies
• Identified high value states and commercial payers
• Reviewed current status of coverage in high value targets
COVERAGE PATHWAYS
• Based on review of existing coverage, identified pathways to expanded coverage and identified likelihood of success
Representative Deliverables
