Project Description

Investment Firm Uses Provider Data for Evaluation of the Traumatic Brain Injury Market

The Client’s Business Need

This case study illustrates the use of payer, hospital utilization and other reimbursement data to assist with investment decision making.

An institutional investor contacted us regarding a potential investment in a Seattle, Washington based company. The company was developing a product line of non-invasive systems to diagnosis and to monitor the regression or progression of the Traumatic Brian Injury (TBI) following testing and treatments. Diagnosis and monitoring is possible because the company’s system can be used over the entire TBI spectrum and in a variety of care settings. There is a portable system designed for use in memory centers and sporting events. For moderate care intensive sites of service, such as the skilled nursing facility, the development of a mid-range system was underway. For the most care intensive site of service, the hospital neurology ward and the neurocritical care unit, a high-end system was also under development.

The client’s business need was for us to help them with their investment due diligence. To do this they asked us to provide them with 1) the most current procedure volume data for mild, moderate and severe TBI for several different diagnostic tests and, 2) the TBI patient discharge volume from U.S. based hospitals and emergency departments.

Case Study Univ Payer InterviewsCase Study Digital TRx _Medicare

Our Approach

To determine the TBI diagnostic procedure data and the TBI patient discharge volume, we first had to identify from a vast array of U.S. commercial and public payer databases and selected confidential third-party reports. Once identified we prioritized the most relevant payer databases from which to query, extract and consolidate the payer data.  We often use payer databases for our market intelligence work because we consider this data to be of high quality for the following reasons,

  1. The data is actual and is not forecasted.
  2. The data is current and the availability of historical data for trending purposes.
  3. The data is available for multiple sites of care like the emergency department and the hospital.
  4. The data is derived from reputable sources such as United Healthcare and Medicare.

The Results

Our customized market analysis using actual data determined the TBI diagnostic procedure volume data was larger than the institutional investor had forecasted. In addition the hospital vs. the emergency department discharge data was materially different than the investors were expecting.

A primary reason for the disparity between our findings and the client’s expectations is a result of the data specificity we can achieve in our analysis using payer and reimbursement data when compared to third party, boilerplate-marketing reports, which the client was using.

We use actual, not forecasted, data and from multiple sites of care; not one site of care. This type of data specificity is not possible with the third party, boilerplate-market reports because these reports use forecasted data, often from one site of care, to calculate their “aggregate forecasts”. To further enhance our data specificity, we will conduct longitudinal analysis, which allows us to follow patients as they move between sites of care.

Our high-level of specificity and customized approach to market sizing is cost competitive and uses different research methodologies than the third party, boilerplate- market reports. There is no reason for any company, start up to large multinational to settle for anything less.