Adi Renbaum, President of ANR Consulting, is a seasoned and trusted business advisor to executives of advanced medical technology companies, specializing in health policy, medical economics, and reimbursement strategies. For more than 22 years, Ms. Renbaum has designed and implemented market access strategies for advanced medical therapeutics and diagnostics using a consultative problem-solving approach. Applying her keen understanding of healthcare financing dynamics, she leverages and influences health policies to create access to novel technologies in existing treatment pathways. She helps her clients highlight their technologies’ clinical merits and impact on patients’ functional improvements, and the economic benefits that follow integrating a new technology into the treatment pathway – keys to products’ value propositions for stakeholder adoption, diffusion and payment.
Your vision. Our experience.
Ms. Renbaum has lead several national campaigns for coverage and payment among Medicare and commercial payers, and negotiated payer/provider contracts nationally and regionally. Ms. Renbaum’s experience ranges from complex, hospital-based surgical devices and implants, to drug/device combination products, and office-based procedures and diagnostics. Ms. Renbaum has negotiated directly with Medicare nationally and regionally, national commercial payers (e.g., Aetna, Cigna, Humana, United HealthCare, BCBS Plans), and many regional plans.
She works closely with specialty medical societies to build advocacy and physician consensus to overcome payer barriers. She has secured reimbursement for office-based procedures via new CPT procedure codes developed by the AMA’s CPT Editorial Panel, and educated clients about the Resource-Based Relative Value Scale (RBRVS) for integrating the cost of new technologies into the newly created CPT codes. In addition, Ms. Renbaum has secured additional payment to hospitals for premium-priced new devices used in the Hospital Inpatient and Outpatient Departments through New Technology Add-On Payment and New Technology APC/Transitional Pass-Through Payments, respectively.
Adi delivers results for her clients, in part because she recognizes the role and influence of each of the many stakeholders involved in bringing a novel medical technology into every day clinical practice. She has worked with the constellation of influencers for new medical technology: groups of payer medical policy experts; practicing physicians and leading medical opinion leaders; Medicare administrators; hospital financial managers and their reimbursement staff; and clients’ teams and external advocates, to cultivate high-performance teams that achieve intended strategic objectives. To support her clients’ objectives, Ms. Renbaum draws from an extensive network of experts, including clinical trialists; health economists and data analytics experts; coding and technical reimbursement experts, to bring together the necessary skills to solve problems and advance her clients’ business strategies.
Adi holds an MBA from the Fuqua School of Business at Duke University and a BA from the George Washington University in Washington DC.
Ablation catheters - (esophageal; dermal, venous)
Coronary disease diagnostics and treatments - (cardiac catheterization; cardiac CT, other non-invasive cardiac diagnostic tests, implantable/wearable cardioverter defibrillators)
Diabetes – (continuous glucose monitors; strips, meters and insulin pumps)
Injectables – (hepatitis C; multiple sclerosis; human growth hormone, anti-VEGF for Age-related macular degeneration and diabetic retinopathy)
Minimally-invasive surgical procedures (e.g. nasal sinus surgical endoscopy, with balloon dilitation; endoscopic insertion of device to minimize overactive bladder leakage)
Ophthalmic implants, procedures, diagnostics and devices – (corneal and retinal)
Peripheral artery disease – (implantable stents and angioplasty balloon catheters)
Spinal stabilization implants – (pedicle screws; fusion devices)
Presentations, Lectures and Publications
Industry Representative: CMS’ Medicare Evidence Development & Coverage Advisory Committee (MEDCAC), 2017-2019. Served on March 2017 meeting, “Health Outcomes in Heart Failure Treatment Technology Studies.”
“Real World Perspectives: Pitfalls and Keys to Success for coverage and reimbursement in 2018” MDMA 20th Coverage Reimbursement and Health Policy Conference, November 2017.
“The Process of Obtaining Category One CPT Code: Where Are We With Non-thermal Saphenous Ablation?” International Vein Congress, April 2017.
“Why do coverage and payment rules for new technologies affect physicians so significantly? Or, When will I know the rules of the game before playing it?” Expert Venous Management (Affiliated with American Venous Forum), June 2016.
“What Effects are ACA’s Changing Reimbursement Incentives Having on Physicians?” Seventh Annual Venous Symposium, April 2016
“AVF 2016: Day of Innovation and Science: What data will lead to changes in coverage?” American Venous Forum Annual Conference, February 2016.
Regular Guest Lecturer: Introduction to U.S. Health Services Delivery. Department of Health Policy and Management, Milken Institute of Public Health, GWU, Washington DC.
Major Barrier Eliminated for Treating Patients with MOCA Vein Ablation; New CPT® Codes Effective January 2017. VEIN Magazine, Winter 2017.
Blog: Disruptive Women in Healthcare: www.disruptivewomen.net
ANR Consulting has affiliated with or attended the following conferences NAMCP, MDMA, HFMA, AMA, AAO, ACP, SIR, VIVA.
Settings of Care
Freestanding Ambulatory Surgery Centers
Hospital: Outpatient, Emergency, Radiology/Nuclear Medicine Departments
Therapy Services: Speech; Physical
Pharmacy: retail; PBMs; specialty pharmacies; compounding pharmacies
Diagnostic Testing: telemedicine, remote retinal imaging, point of service tests, PET, CT