12TH SEMI-ANNUAL DIAGNOSTIC COVERAGE AND REIMBURSEMENT CONFERENCE WEST

FEBRUARY 6-7, 2018 | SAN DIEGO, CA

HILTON GARDEN INN SAN DIEGO BAYSIDE

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DAY TWO | WEDNESDAY, FEBRUARY 7

8:00 REGISTRATION & WELCOME COFFEE

8:20 CHAIRPERSONS’ OPENING REMARKS
Brandon Richardson, Business Development/Client Strategist, LASH GROUP


8:30 CONSUMERIZATION OF CLINICAL LABORATORY TESTING & SERVICES IMPACT ON REIMBURSEMENT

  • Direct-to-consumer laboratory testing & services:
    • Patient empowerment & consumerization trends
    • Opportunities in innovative access strategies
  • Direct to consumer testing, at home testing & remote diagnostics
  • Changes in consumer behavior impact on healthcare
  • Examples & insights into innovations

Mark S. Girardi, Senior VP, GFK HEALTH

 

9:15 ADVAMED’S VALUE FRAMEWORK FOR ASSESSING BENEFITS OF DIAGNOSTICS

  • Designed for use by multiple healthcare stakeholders
  • The 4 key value drivers:
    • Clinical Impact
    • Non-clinical patient impact
    • Care delivery revenue & cost impact
    • Public/population impact
  • Defining evidence as it relates to value

Chandra N. Branham, VP, Payment & Health Care Delivery Policy, ADVAMED

Tony Grover, VP Business Development, BANYAN BIOMARKERS, INC.

 

10:00 COFFEE & NETWORKING BREAK

 

10:30 MASTER CLASS: IMPACTFULLY DEMONSTRATING VALUE IN RELATION TO THE TARGET POPULATION & TREATMENT
A critical challenge faced by reimbursement executives working towards accessing reimbursement for new diagnostics is to demonstrate value and ultimately prove the efficiency and usefulness of the product to healthcare payers, therefore positively influencing coverage decisions. There is often times a difference of perspectives between payers and industry when defining value, as while the first will focus on optimized patient outcomes and cost-savings, the second will frequently focus more on the test’s additional benefits. To make an impact and stand-out in a competitive market, it is critical to adopt the payer’s perspective when developing the value dossier and pitch, taking into account the insurer’s focus areas.

  • Highlighting HE market analysis & impactful metrics
  • Impact of test on regimen decisions & full treatment
  • Demonstrating economic benefits & savings

Diane Johnson, VP Market Access & Reimbursement, EXACT SCIENCES

Philip Parks, MD, MPH, FACOEM, Senior Director & Head of Medical Affairs, EXACT SCIENCES

 

11:30 CASE STUDY: PROFILING VALUE LEAKAGE IN THE PATIENT JOURNEY TO ESTABLISH A BASIS FOR COVERAGE

  • Profiling the patient journey
  • Assessment of key stakeholder roles & value perceptions
  • Identification of unexpected “value traps”
  • Putting it all together:
    • Diagnostic performance & key unmet needs alignment
    • Establishing a rationale for coverage
    • Guiding evidence development

David Parker, Senior VP, Diagnostics Solutions, PRECISION FOR MEDICINE

 

12:15 LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES

 

1:15 ESTABLISHING PRACTICAL REIMBURSEMENT STRATEGIES: FOCUS ON TIMELINE & BUDGET
Many diagnostic corporations recognize it can take up to 5-6 years between diagnostic development and obtaining of reimbursement which, if not accounted for, can lead to pressure from hierarchy and company board members. This common pitfall in the overall reimbursement strategy must be addressed early, to ensure relevant budget is available to support coverage efforts and the necessary time to obtain positive decisions from payers. Further, disseminating a clear understanding of the reality of reimbursement timelines to CFO, CMO, CEO and board members will ensure a robust plan is set up front.

  • Recognizing necessary time to generate the right evidence
  • Communicating the required steps to hierarchy & board
  • Calculating the budget to support time to reimbursement
  • Robust planning from reimbursement strategy inception

Jeffrey Jones, Executive VP, Commercial Operations, SKYLINE DX

 

2:00 PANEL DISCUSSION: RECENT POLICIES’ IMPACT ON DIAGNOSTICS COVERAGE & REIMBURSEMENT

  • PAMA implementation & potential changes
  • LCD process impact & potential developments
  • FoundationOne NCD & the parallel review pathway
  • Expansion of 14-day rule for ADLT’s & more

Chandra N. Branham, VP, Payment & Health Care Delivery Policy, ADVAMED

Laurie Howard, VP Payer Policy & Relations, LABORATORY CORPORATION OF AMERICA

Ester Stein, MBA, Director, Corporate Reimbursement Government Affairs, ABBOTT LABORATORIES

Hannah Murphy, Executive Director, COALITION FOR 21st CENTURY MEDICINE

 

3:00 CLOSING REMARKS & CONFERENCE CONCLUSION

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We hope to see you at the conference!

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