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Utilization Management “New Normal” Means Challenges with Prior Authorizations and Appeals

Spine surgery faces utilization management challenges that are influencing patients’ access to care and surgeons’ abilities to navigate the current payor environment. Device companies can better serve surgeons and their patients by remaining abreast of changes to the payor climate.  

In Part I of this overview, Kim Norton discussed prior authorization in general. In this second article, she further delineates what surgeons are experiencing with two specific, important issues, both of which significantly impact patient access: commercial health plans not allowing prior authorization in certain circumstances, and an appeals process that is increasingly skewed toward the health plans.

Spinal Kinetics Founder Shares Keys to Startup Success

Many of the lessons that Tom Afzal has applied throughout his career he learned while working at American Hospital Supply Corporation—one of the largest medical device companies in the ‘70s-‘80s—his first professional position after college. As part of a management path program, Mr. Afzal was required to work in many functional areas of the company—sales, marketing, finance, production, R&D, quality, etc.

“They threw everything at us, and we learned so much,” Mr. Afzal said. “As part of the program, they allowed us to make a lot of decisions and take some risks. Everybody got a chance to make a mistake. You just could never make the same mistake twice. But they wanted you to take risks and not be afraid of doing so. The corporate culture was based on doing and merit, and I learned the majority of the principles that shaped my career and philosophy while working there.”

The experience cemented his personal philosophy: work hard, play hard, enjoy what you do.

Anika Therapeutics Takes Major Step in Strategic Transformation with Acquisition of Parcus Medical and Arthrosurface

These implant portfolio acquisitions diversify Anika’s revenue streams across a continuum of care in orthobiologics and sports medicine while positioning the company to expand on a base of fast-growing revenue. Further, Parcus and Arthrosurface fast-track Anika’s buildout of their hybrid salesforce with the addition of 40 direct reps and over 200 distributors.

Armed with these new tools for 2020, Anika looks ready to complete a major step in its five-year strategic plan to become a leader in joint preservation and restoration.

Can Technology Help DePuy Synthes Close the Gap in Their Knee Franchise?

What is the last exciting news you recall hearing about DePuy Synthes’ knee franchise? Its competitors have dominated both industry news cycles and the market itself. Rajit Kamal, Vice President and Global Knee Franchise Leader at DePuy Synthes, aims to change that through a combination of hardware and technology.

Muvr Labs Brings Wearable Technology to Joint Replacement Recovery

“Muvr is a full-stack recovery company,” said Robert Winder, Co-Founder and Chief Operating Officer of Muvr Labs. “That means that we have physical therapists to treat patients; we have technology that assists in the treatment of the patients, including wearable sensors and an app; and we also have technology that helps physical therapists get scheduled and optimize the route that therapists take when they’re going to treat patients in their homes.”

The company’s mission is to deliver as much technology as possible into the physical therapy space to optimize the therapy itself, the care given to the patient and the back office aspects, like scheduling and billing.

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