The Opportunity

The client needed a strategy and playbook to increase the market penetration and reimbursement for their disruptive and innovative technology.

Our Work

We offered retainer-based advisory services to develop and support implementation of an evidence-based, strategically-focused playbook to achieve better market penetration in clinics and coverage by payers.

We led efforts to optimize Medicaid coverage by using key marketplace levers (i.e., expert consensus statement, provider advocacy engagement, and state legislation strategy).

We also implemented a continuous process improvement effort for processing appeals from denied Medicaid claims​.

We helped with client market penetration objectives by leveraging the THCQ Consulting team’s existing relationships with national leading community pharmacy stakeholders for clinical partnerships.

The Outcomes

The client utilized results from a Medicaid coverage and reimbursement patterns analysis performed state-by-state across the country​

We developed and implemented a prioritized provider and state legislator advocacy (via lobbying firm) effort for Medicaid legislation in Pennsylvania​.

We established partnerships between the client, important pharmacy businesses, a leading regional insurance brokerage firm (for employer strategy), the national employer coalition of coalitions, and mental health organizations.

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