What we do

The Pinnacle Health Group supports medical device, pharmaceutical, biotechnology, medical technology manufacturers and other health care organizations. We create innovative programs that identify and promote the value of our client's products and services. We work closely to develop, implement and focus strategic plans by providing a seamless array of support services, all working toward the same goal.

The Pinnacle team has a successful track record of developing market strategies and obtaining appropriate reimbursement for new technologies, medical devices and drugs during Phase I, Phase II, product launch and throughout the commercialization process.

Among the strategic assessments performed by The Pinnacle Health Group the following projects have been successfully developed:

Reimbursement Strategy and Coding

  • Strategic planning and tactical implementation and timelines for appropriate technology and pharmaceutical coding;
  • Development of and coordination with professional societies to obtain appropriate CPT coding;
  • Successful DRG, ICD-9 and HCPCS code application and implementation;
  • Successful application and implementation of new technology and pass through device codes for new services, devices and drugs under the hospital outpatient prospective payment system (HOPPS);

Coverage Strategies

  • Assessment of various reimbursement strategies for drugs, biologicals, medical devices, therapeutics and diagnostics;
  • Listing of new pharmaceuticals on standard national formularies as well as large PBM, managed care and small plan formularies;
  • Successful reimbursement strategies for FDA cleared devices that are distributed as pharmaceuticals through a pharmacy distribution network;
  • Formulation of consensus guidelines to expand payer coverage and support product positioning for diagnostics, therapeutics and medical devices;
  • Convening payer advisory boards to develop coverage and payment guidelines for new technologies and drugs.

Economic and Marketing Strategies

  • Economic and clinical outcome reviews that encompasses epidemiological, medical, and financial parameters;
  • Development of health economic modeling and economic assessment tools and publication strategies;
  • Development of primary and secondary market assessments for diagnostics, therapeutics and medical devices;

We are particularly experienced in assisting companies with new technologies and products prior to FDA approval/clearance. Pinnacle provides specific support for pre-launch marketing strategies that incorporates an understanding of payer guidelines and opportunities. The optimal positioning of new products is customized to optimize the return on investment for each of our clients. By capturing specific outcomes information during clinical trials, the Pinnacle team has enabled clients to garner optimum pricing and differentiate their products from formidable competition. Additionally, we have assisted our clients with the development of landmark publications that have enabled companies to disseminate critical economic based data to create a competitive advantage in the market. Through the tactical implementation of reimbursement strategies and managed care contract negotiations we have helped our clients to overcome financial objections and expand market opportunities.

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© 2020 The Pinnacle Health Group