Focus Panels

Overview

Payer Insights’ Medical Director Focus Panels provide direct, actionable insight into four key factors affecting whether your product will be approved for coverage by one or more insurers:

  1. The payer’s technology review process,
  2. The payer’s views on the current treatment continuum of the disease and where your technology fits,
  3. The payer’s views on the current status and strength of your clinical studies, publications and independent assessments, and
  4. The payer’s impression of your product’s “clinical utility.”

The Panel offers you an opportunity to both present information on your product during an interactive session, as well as observing the panel’s responses during a moderated questions and answers session.

The Panel provides an opportunity to identify your goals for the meeting, and present information on the disease state, treatment continuum, and your technology’s features, clinical benefits, and health economic information.

Actionable information gained from the panel meetings generally includes: Identification of coverage gaps and recommendations for necessary actions which may follow.

Panel Medical Directors

Payer Insights’ network of active medical directors is the heart of our service. It provides direct communication with knowledgeable professionals who are well versed in the current state of the industry.

Payer medical director panelists:

  • Are thoroughly vetted.  
  • Currently serve as active commercial decision makers and direct influencers for coverage reviews within their respective health plans.
  • Represent local, regional, and national payers from across the United States, with 250K up to 40MM covered lives in commercial, government, self-pay and workers compensation markets. 
  • May also be involved with PPO’s, IDNs, and ACO’s as well as academic affiliated systems.
  • May be recently retired from Medicare.

The identities of the panel members are kept confidential, and in some cases, the panel may not need to know the identity of the manufacturer.

Focus Panel Format

Panels are conducted in a double-blind format to insure the confidentiality of both our clients and the medical directors. Often the device will be mentioned by brand. Panel members are provided with executive summaries and background information in advance of the meeting to allow for their familiarization as well as an existing review of their own policies.

The panel is divided into two sections: Client Presentation and Moderated Questions and Answers Session.

• Client Presentation

Prior to the panel date, Payer Insight’s staff reviews the presentations with our clients and their presenters who often are both company experts as well as a practicing clinician.  Recommendations are provided on format to ensure presentation clarity. The presentations are often interactive among the presenters and panel members with the moderator maintaining discussion focus and respect for the time schedule. During the presentation, select company representatives are able to observe the panel in a viewing room located “behind the glass” of the panel room. After the presentation, the presenters return to the viewing room to observe the moderated discussion, but are able to return to the presentation room for additional discussion as needed.

• Moderated Question and Answer Session

A set series of questions is developed between Payer Insights staff and our clients.  During this session, discussions are encouraged to be interactive among the panelists.  The goal of this exchange is to identify both the strengths and weaknesses of the information presented and to better identify existing gaps to coverage. Additionally, client presenters have the opportunity to return to the moderated session and provide additional details should specific questions arise. The moderator maintains the focus of discussion to make sure questions are answered, and final conclusions and recommendations are captured from the panel.

Panel Logistics

  • Panels are typically hosted in Washington, DC, but other locations are available.
  • Panel duration ranges from 2.5 to 6 hours, depending on the individual client needs. In general, 3 – 4 hours is sufficient.
  • Payer Insights manages all logistics, communications, coordination, and budgets for the panels.
  • Transcripts and summary reports can be quoted, if desired. 
  • No photos or recordings are allowed during the session.