분자 진단의 근거 기반 상환 컨퍼런스 - 첫째날


Evidence-Based Reimbursement of Molecular Diagnostics Banner

IVD 제품 또는 LDT 어세이의 상업적 성공은 현재 의료 환경에서는 더욱 더 어려워지고 있습니다. 의료 예산을 삭감하면서 고가의 분자 검사가 다수 출시 되고 있어 기존 방식으로 대응해 온 지불자에게 혼란을 야기하고 있습니다. 새로운 PAMA 규제 및 민간 지불자의 역할 확대에 의해 동종업계 관계자와의 정보 공유와 최신 동향 논의가 중요해지고 있습니다. 본 컨퍼런스는 참가자에게 보상과 상환의 모든 문제에 대해 폭넓게 논의하고 해결책을 모색할 기회를 제공하는 유일한 포럼입니다.

첫째날 | 둘째날

11월 18일(화)

12:00 pm Conference Registration

CMS의 미래에 관한 설명 

1:20 pm Chairperson's Opening Remarks

1:30 Medicare Law and Lab Tests: Changing More than the Price

BruceQuinn2Bruce Quinn, M.D., Ph.D., Senior Health Policy Specialist, Foley Hoag, LLP

A new Medicare law, PAMA 2014, has triggered the biggest changes in over three decades for lab tests. While much attention has focused on pricing changes with a new market-pricing changes, this presentation will highlight major reforms to local coverage, nationalization of coverage, and increasing the power of guidelines that are being caused by new legislation.

1:50 Medicare Payment for Diagnostics, Speed Bumps or Road Blocks

JohnWarrenJohn Warren, Senior Director, Health Policy, McDermott Will & Emery

As the science and technology behind diagnostics continues to evolve at a rapid pace, Medicare payment has struggled to keep up with the times. This session will provide insight into the background of Medicare's Clinical Lab Fee Schedule, discuss how new tests are evaluated, and take a look at some of the factors that keep the Fee Schedule a step behind the state of the art. Proposed changes to the Fee Schedule for 2014 will also be reviewed.

2:10 Industry Evolution: Responding to the Changing Tides of Payment Reform

MicheleSchoonmakerMichele M. Schoonmaker, Ph.D., Vice President, Government Affairs, Cepheid

CMS and other payors are moving from fee-for-service to fee-for-value based reimbursement systems. New methods for pricing diagnostic tests are being established, forcing laboratories and manufacturers to re-think their value proposition(s) for new diagnostic tests under bundled payment systems. This session will focus on potential economic data requirements that will help test developers be better prepared to navigate the evolving reimbursement landscape.

2:30 Panel Discussion with Speakers of the Session

Moderator: John Warren, Senior Director, Health Policy, McDermott Will & Emery

3:00 Reimbursement of Advanced Diagnostics in the Context of a Broken & Evolving System: Real World Perspectives & Examples 

BrianGorinBrian S. Gorin, MBA, Managing Principal, Analysis Group

Diagnostics developers need to formulate relevant value propositions and demonstrate clinical utility to stakeholders in the context of a broken business model. Diagnostic tests were historically subject to fee schedules based on cost, not value. Valuable tests don't receive adequate reimbursement, are abandoned, or under-invested in. In 2016, the system is due to change, aligning diagnostic reimbursements more closely with market forces. Hear about failings in the current system, implications of changes on the horizon, and discuss examples.

3:30 Networking Refreshment Break  

보상과 상환 전략 

4:00 Panel Discussion: Reimbursement of Stand-Alone versus Companion Molecular Tests

Moderator: Felix Frueh, Ph.D., CSO, Human Longevity, Inc.

Panelists: Jerry Conway, Vice President, Reimbursement & Payer Strategy, Foundation Medicine, Inc.

Benjamin Eckert, Executive Director, Market Access, Metamark Genetics

Jessica Roth, Director, Health Policy & Reimbursement, Roche Diagnostics Corporation

5:00 Close of Day and Registration for Dinner Short Course

5:30- 8:30 pm SC2 Dinner Short Course: Reimbursement of Cancer Genomic Analysis*

Instructors:

JerryConwayJerry Conway, Vice President, Reimbursement and Payer Strategy, Foundation Medicine, Inc.





JorgeLeonJorge Leon, Ph.D., President, Leomics Associates, Inc.

  • Overall situation of the reimbursement landscape today
  • Coding, coverage, policies and payment fees for cancer genomic tests
  • The Medicare/CMS new view of the value of new tests
  • The view from large private payers
  • How to generate cost effectiveness data that payers will buy into
  • How to generate clinical utility data that payers will endorse
  • Case studies in pathology, molecular diagnostics, proteomics, gene expression, next-generation sequencing

*Separate registration required

* 주최측 사정에 따라 사전 예고없이 프로그램이 변경될 수 있습니다.



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