Understanding Payer Expectations To Cover & Reimburse Diagnostic Tests

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Payers are willing to cover and reimburse an advanced diagnostic that impacts treatment decisions and improves patient outcomes while ensuring limited healthcare care dollars are being used in a cost-effective manner. It’s important that the advanced diagnostics industry both understand and appreciate the payer’s perspective, and expectations, when seeking coverage and reimbursement.

Gordon Brown
Managing Partner

Gordon has nearly 30 years of experience in healthcare including pharmaceutical, clinical diagnostics and advanced diagnostics. He was most recently the Senior Director, Global Revenue and Reimbursement Operations at Genomic Health (GHDX) where he had global responsibility for patient access programs, payer contracting and revenue cycle operations. He was also the functional lead for utilization, payer and coverage strategy for the US and international markets. Gordon has also worked at Pfizer, Quest Diagnostics, Esoterix, LabCorp & Orchid Cellmark. He currently provides guidance and leadership for a growing portfolio of advanced diagnostic innovators looking to launch commercially or optimize coverage and reimbursement of an existing test. Gordon has directly impacted successful public and private coverage and reimbursement on four advanced diagnostics to date with several others in process. He has led market expansion in the United States, Canada, Europe, Asia and South America. Gordon also develops and leads best practice efforts in advanced diagnostics commercialization including data development, utilization, coverage and ultimate reimbursement across internal and external stakeholders. He also offers the unique ability to develop overall strategy and support tactical execution if required.