Project Description

Why this Newsletter

We are sending this brief as way to provide you with practical ideas on how to use reimbursement policy and data to help you adjust and define your business plans and objectives.

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With the deadline to enroll in the Affordable Care Act (ACA) marketplace now a couple of weeks away, much attention is being given to the total number of Americans who have and who are forecasted to enroll.  This national number is not particularly relevant for most medical device manufacturers.  A more useful number is the total enrollment per state because the ACA insurance market is run at the state level.   States with large enrollment like California, New York and Connecticut cannot off-set insurers’ margins which are being squeezed in states with low enrollment like Arizona and Texas.

Another important state number is the balance of healthy to sick enrollees.   The hypothesis is healthy enrollees use fewer medical resources and as a result offset enrollee who do use them.  However, insurers in states with a higher than normal proportion of sicker enrollees may feel  squeezed.

This could be a good time to revisit your state-level sales forecast and determine if any near term (higher or lower) adjustments are warranted.  If you need state enrollment numbers, we may be able to help. Contact Sonia Vittori at s.vittori@rowinskigroup.com

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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

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