Monday, October 12, 2020

Reimbursement is not Inherently Dangerous, but Unforgiving of Neglect

This morning I had the chance to do a 45 minute interview on diagnostics and payers for a class being held at ASU in its diagnostics policy center.   

Both the interviewer, Pierre Casseigneul (founding CEO of CareDx) and I have pilot's licenses, though mine's been inactive for quite a while.   

The discussion reminded me of a plaque I've had for decades:  Aviation is not inherently dangerous, but it's terribly unforgiving of any carelessness, incapacity, or neglect.

Like aviation, health-tech reimbursement is partly intuitive but our health system is overlaid with very complex, unavoidable, and arcane rules that take a long time to master.   And they are unforgiving of neglect.

And any major mistake can trap a company very fast.  

  • For example, a company might start with $500,000 in angel funds and only learn a year later, after much invested time and late nights, when seeking Series A funds, that its inpatient product is bundled to a hospital inpatient DRG and will be nearly impossible to sell or to get further funding.  
  • Or a scientist founder may have no grasp at all of the cost and time and effort to obtain "share of mind" with doctors and become a standard of care.  

But like aviation, when everything goes right, it can be thrilling!