Why this Newsletter 

We are sending this brief to bring to your attention the importance of monitoring  healthcare payers’ decisions and the creation of new payer policies, both events could  impact your company’s income and business objectives. Keeping abreast of healthcare payer changes could be a worthwhile.


Cardiovascular devices could be subject to severe inpatient payment reductions under a proposal released by Medicare in the April 25, 2008 Federal Register.

Per the Register, inpatient payments for pacemakers could decline 13%; defibrillator payments could see a 23% decline and a 32% reduction for stents.  The proposed cuts for orthopedic procedures would not be as severe as cardiology.  Spine payments could experience a proposed 6% decline. However, there is a proposal to increase the payment of 1.4% for hip and knee replacements.

The proposed payment reductions are part of a larger effort to reform the Medicare payment system for inpatient care. There have been no significant reforms to the inpatient prospective payment system since it was implemented in 1984.  Key to the payment reductions, and the reform effort, are two items.  First, a shift to a cost, rather than a charged- based payment system that would go into effect on October 1.  Second, implementing a severity-based system that would go into effect October 2008.

The comment period closes June 12, 2008  for the public to submit comments to Medicare on the proposed payment cuts.  If you would like to discuss the proposed payment reductions and/ or formulate a rebuttal to Medicare before the June deadline contact Rowinski Group at  info@rowinskigroup.com


About Rowinski Group   

Founded in 2004, Rowinski Group LLC is a reimbursement and healthcare payer data analytics consulting firm for medical device, digital health, diagnostics, and imaging companies. Rowinski Group is based in Silicon Valley – San Francisco bay area with offices at selected client locations.

Rowinski Group has two core service offerings; securing codes and reimbursement on behalf of companies and applying healthcare payer data analytics to help solve companies’ complex business issues such as responding to questions from the FDA and U.S. Payers.

Through these service offerings Rowinski Group helps U.S. and international companies build their U.S. market share for the medical technology they are developing and selling. For more information visit www.rowinskigroup.com