The reimbursement of diagnostics is a key consideration for both diagnostic providers and payers. This is true because while 5% - 7% of the hospital cost is incurred through the use of diagnostics, they are used in about 70% of healthcare decisions.
It has been very challenging to develop an optimum price, especially for emerging diagnostic technologies such as molecular diagnostics – because evidence-based pricing does not suffice for such technologies. This complicates the scenario for early movers in diagnostics.
Moreover, there has been an on-going issue with respect to existing technologies, as companies have an immense need to re-consider their pricing strategies to deal with cost and demand versus reimbursement issues.
Hence, it is crucial to identify the best pricing strategies to maintain reimbursement for innovative diagnostics.
In a recent report from BusinessInsights, the analysts conclude:
- A procedure has a higher chance of getting insurance coverage, if it reduces the overall treatment costs.
- The recent reduction made by the CMS in the reimbursement amount for non-facility units is expected to impact the diagnostic devices market especially in the form of a lack of innovation.
- Reimbursement structures are restraining the growth of innovative technologies such as molecular diagnostics.
- An OEM’s pricing is fundamentally based on its desired Return-on-Investment and the overall cost of manufacturing its equipment.
- Fair Value Pricing and Risk Sharing Pricing are the new methods of pricing within healthcare diagnostics.
Read more in the full report.
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