Strategic Reimbursement Planning: Aligning Value Across Stakeholders for Commercial Success

Effective reimbursement strategy for your innovation is not only about securing codes, coverage, and payment, it’s about aligning your product’s value proposition with the needs of all key stakeholders across the healthcare ecosystem. Our approach to strategic reimbursement planning and execution is predictive, integrated, and tailored to your innovation. It's the cornerstone of a successful commercialization strategy.

We develop comprehensive, forward-looking reimbursement strategies that anticipate market dynamics, address payer expectations, and equip providers with the tools they need to adopt your technology. By articulating clinical, economic, and patient-centered value, we help you establish a compelling case for access and support successful product commercialization.

We support you across the entire reimbursement lifecycle, from early planning through post-market execution. Whether you're engaging with payers, providers, health systems, or policymakers, we position your product for long-term market acceptance and growth.



Market Intelligence

PRIA partners with MedTech innovators early, delivering strategic market intelligence that informs product planning, de-risks commercialization, and aligns innovation with payer, provider, and patient needs.

• Market Assessments
• Strategic Product Planning
• Competitive Landscape Analysis

Coding Strategy & Development

PRIA helps you navigate the evolving coding landscape and ensure your innovation is accurately and optimally represented.

• New code applications (CPT, ICD-10-PCS, HCPCS)
• Coding gap analyses
• Procedure-to-technology mapping
• Provider and internal team education

Coverage Strategy & Evidence Development

Coverage is earned through clarity and credibility. We build strategies that align your clinical evidence with payer expectations.

• Coverage landscape assessments
• Clinical evidence mapping and health economic support
• Payer value dossiers and HTA preparation
• Real-world evidence strategy to support adoption
  

Payment Strategy & Modeling

PRIA’s strategic experts’ model financial impact and optimize payment pathways to support sustainable access and provider adoption.

• Payment benchmarking (Medicare and commercial)
• DRG/APC impact analyses
• NTAP and TPT support for new technology payments
• Inpatient and outpatient reimbursement strategy
  
  

Commercial Readiness Tools

PRIA equips your teams with practical resources that bridge the gap between strategy and execution.

• Payment benchmarking (Medicare and commercial)
• DRG/APC impact analyses
• NTAP and TPT support for new technology payments
• Inpatient and outpatient reimbursement strategy
  
  

Market Access Strategy: Powering MedTech Innovation Through Proven Access Pathways

At PRIA Healthcare, we believe that a great product alone isn’t enough, true success in MedTech comes from ensuring your innovation reaches the patients and providers who need it most. That’s why market access is at the heart of everything we do.



We build and execute comprehensive market access strategies that accelerate adoption, overcome access barriers, and position your technology for long-term growth. By aligning clinical, economic, and real-world value with the priorities of payers, providers, and policymakers, we help you transform innovation into impact.

Access Strategy Development

We craft tailored, end-to-end market access roadmaps designed to support your commercialization goals - whether you're preparing for launch or scaling post-market.

• Payment benchmarking (Medicare and commercial)
• DRG/APC impact analyses
• NTAP and TPT support for new technology payments
• Inpatient and outpatient reimbursement strategy
  
  

Health Economics & Value Messaging

Demonstrating the economic and clinical value of your technology is essential. We help translate your data into persuasive, actionable narratives for decision-makers.

• Cost-effectiveness modeling
• Budget impact analyses
• Value proposition frameworks for different stakeholders
• Payer communication strategy
  
  

Evidence Alignment for Access

We guide you in generating the right data, clinical, economic, and experiential, to support coding, coverage, and
payment success.

• Evidence strategy that supports payer needs
• Real-world evidence and outcomes planning
• Alignment with reimbursement and policy objectives
  
  

Access Enablement Tools

We provide tactical assets and training that empower your team to activate your market access strategy in the field.

• Field team training on payer messaging and policy navigation
• Patient access resources and support tools
• Billing and coding education for provider partners
• And so much more
  
  

Reimbursement Hotline Services: Expert Support When It Matters Most

PRIA’s Hotline Services provide your team, providers, and patients with real-time access to reimbursement and market access expertise. We ensure the swift resolution of questions and challenges that arise throughout the commercialization journey.

Our knowledgeable specialists offer personalized guidance on coding, coverage, payment, and access issues, helping to reduce delays, streamline workflows, and improve satisfaction across all stakeholders.



Key Features:

On-Demand Reimbursement & Access Support

• Immediate answers to complex coding, billing, and payer inquiries
• Dedicated help navigating authorization, appeals, and benefit verification
  
  

Proactive Provider Assistance

• New Account Support to streamline adoption, collaborating with your field team to answer questions before they arise.
  
  

Issue Tracking & Reporting

• Detailed analytics to identify common barriers and inform strategy refinement
  
  

Flexible Integration

• Seamless coordination with your field teams, call centers, and patient support programs
  
  

Reliable Expertise, Anytime You Need It

• With PRIA’s Hotline Services, you empower your network with the knowledge and support to overcome access challenges, accelerating adoption and driving commercial success.

Payer & Stakeholder Engagement: Strategic Influence That Unlocks Access and Drives Adoption

In today’s rapidly evolving healthcare environment, securing reimbursement and widespread adoption demands more than strong clinical data, it requires a deliberate, insight-driven engagement strategy with the right stakeholders at the right time. From national and regional payers to providers, health systems, and policy influencers, PRIA helps you build trusted relationships that move the dial on coverage and accelerate market penetration.

We understand that payer engagement is not transactional - it’s transformational. And it starts well before product launch. Our approach is grounded in the belief that clinical development, evidence strategy, and market access planning must be tightly aligned from the outset to anticipate payer expectations and reduce barriers to adoption.

With deep knowledge of payer decision-making, evolving policy dynamics, and unmet information needs, PRIA empowers MedTech innovators to enter the market with confidence—and impact.

(Step One) Strategic Diligence: Laying the Groundwork for Informed, High-Impact Engagement

Effective engagement begins with intelligence. We lead a rigorous discovery process to map your landscape, identify key access drivers, and develop a strategic framework that ensures your outreach is credible, timely, and tailored to the payer mindset.

Key Activities:

Stakeholder Mapping & Influence Strategy

Identify and prioritize payer, provider, and policy decision-makers based on clinical indication, site of care, and geographic relevance

Coverage Policy & Evidence Requirements Assessment

Analyze existing payer coverage, precedent policies, and clinical expectations to reveal gaps, risks, and opportunities

Clinical & Economic Value Alignment

Ensure your clinical development plan, endpoints, and outcomes align with payer expectations and value frameworks
—starting early

Messaging & Positioning Strategy

Develop evidence-based, payer-facing value narratives that resonate across cost, quality, and outcomes metrics

Engagement Roadmap Development

Create a phased, multi-stakeholder outreach plan to build credibility, address objections, and maintain momentum

(Step Two) Execution & Advocacy: Engaging Payers with Precision and Purpose

Armed with insights, PRIA leads the charge in executing your engagement strategy—translating data into dialogue and dialogue into access. Our experts act as strategic guides and tactical executors, ensuring every interaction builds trust and advances your commercialization goals.

Key Activities:

Payer Meeting Preparation & Facilitation

Lead or support meetings with targeted materials, tailored messaging, and clear objectives that showcase your
technology’s value

Advisory Board Development & Moderation

Organize and facilitate payer, provider, or multi-stakeholder advisory boards to gather feedback, validate assumptions, and build advocacy

Ongoing Stakeholder Communication

Establish and manage communication cadences with decision-makers to sustain engagement and respond to evolving needs

Medical Society & Advocacy Alignment

Engage key influencers to support coding efforts, shape policy, and reinforce the clinical legitimacy of your technology

Feedback Loops to Strategy

Translate insights from the field into actionable refinements for your evidence plan, value messaging, and broader
access strategy

A Changing Market Demands a Smarter Strategy

The reimbursement landscape is shifting. Value-based care, prior authorization pressures, and increasingly sophisticated payer evaluation processes have raised the bar for market entry. At PRIA, we don’t just keep up - we stay ahead.

Our team brings decades of experience working alongside commercial and government payers, and we understand what it takes to influence decisions. We know the questions they’ll ask and we help you answer them before they’re even raised.

The Time is Now. Engage Early, Align Strategically and Execute with Confidence.

With PRIA as your partner, you’re not just entering the market, you’re shaping how the market receives you.