Lynx Advisors Pty Ltd’s Post

📢  We’re thrilled to announce a significant strategic milestone with the approval of a new US Insurance Code Approved for our flagship technology, the NeuroNode®. This pivotal approval means the NeuroNode® is now officially recognised as a reimbursable medical device in the US, opening doors to a US$4,300 reimbursement that was previously unavailable. What does this mean? Once this becomes effective on 1 October 2024: 🌟 It results in a material benefit to the business’ operations in the US. 🌟 Represents a substantial opportunity to expand our wholesale distribution model as part of our ‘NeuroNode® Only’ strategy. 🌟 Both Control Bionics and our US partners will be able to apply for this reimbursement for customers covered by Medicare and Medicaid, and we’ll also work to have it covered ‘in-network’ with private insurers. This milestone accelerates our growth trajectory and strengthens our commitment to improving lives through innovative assistive technology. We look forward to the opportunities this new approval will bring! Roger Hawke Jeremy Steele Peter S Ford David Falk Kerry Series Lindsay Phillips Joe Durak Kanak Sahasrabudhe Adi Deshpande #ControlBionics #NeuroNode #ASX #HealthcareInnovation #MedTech #Medicare #Medicaid #USHealthcare #AssistiveTechnology

Some positive news from Control Bionics today. You can also read more about the incredible work they're doing in this OnImpact article: https://lnkd.in/gMSepr64

To get a software-enabled #medicaldevice to market, you need an integrated data strategy that grows with your product and meets the unique needs of stakeholders like the #FDA, insurance payors and healthcare providers. Orthogonal and MATTER Chicago's latest joint #webinar featured a panel of #MedTech experts who spoke on the challenges of meeting stakeholder requirements for connected #medicaldevices. Listen to the recording and read the key takeaway points here: https://lnkd.in/eNRh8YvH #digitalhealth Kwame Ulmer, Christian Johnson, Jennifer McCaney

According to the American Medical Association, 1 in 3 doctors has had a serious adverse event for patient care during prior authorization. That’s a huge loss! And if you are a physician, you must already agree that prior authorization is costly and causes patient care delays. Good news is you can still avoid the burden. Here are a few ways how: 1/ Prescribe cheaper alternatives to high-cost drugs, based on evidence-based guidelines, and always choose generic drugs when possible. 2/ Outsource prior authorization to a great RCM company or get an in-house team for all the verifications. Streamline EHRs and workflows to deal with the requirements! 3/ Push payers for fewer prior authorization and faster processing by expediting the appeal processes and direct communication. A good medical billing and RCM company would do it for you. All else failed? Fight! ♦ Send out a letter to the payers defending your prescription.  ♦ Bill the insurer for your time.  ♦ Encourage your patients to send a letter to their insurers. ♦ Or reach out to your state insurance commissioner, explaining the issue. Still failed? Let’s talk! Send me a message so I can consult for FREE with you on your specific situation. I genuinely want you to sail through the ups and downs of our challenging healthcare system. #medicalbilling #priorauthorization #outsource #medicalbillingservices #BellMedEx

Navigating Medicare can be particularly challenging for beneficiaries under 65 with disabilities and AI matchmaking can help. According to KFF, 23% of this group struggles to find suitable insurance, compared to 14% of those over 65. Healthpilot, founded in 2020, aims to simplify this process by using advanced analytics and AI to match enrollees with the best plans based on their healthcare needs. As Medicare Advantage (MA) grows in popularity, insurers like Humana are shifting focus to government plans despite recent financial challenges. #Medicare #Healthcare #Insurance #DisabilitySupport #AI #HealthTec #ai #artificialintelligence #innovation #automation #drugs #pharma #pharmacybenefitsmanagement #investments #healthcarefinance https://lnkd.in/eHC7it62

While we might debate the essential role of #insurance as a basic need in our daily lives, I assure you that insurance can often be a barrier to accessing health necessities. Take, for example, Schedule 2 vaccines like the HPV vaccine, which protects against certain cancers. Here’s how the cycle unfolds: If you’re a full-time employee, you likely receive drug benefit insurance, with premiums shared by you and your employer. Suppose you need a Schedule 2 medication that doesn’t require a prescription for purchase. However, insurance will typically require a prescription, which means you need to book an appointment with your physician. For their practice, this is entirely fair. Now, here’s the catch: you’re working full-time, and your hours likely overlap with your doctor’s office hours. So, you have to take time off work to visit the clinic, even though the prescription could have been easily assessed and prescribed by a pharmacist, who may have more flexible hours to accommodate your schedule. Do you see the issue here? Does insurance actually serve as a barrier to healthcare access? Check into #PPNs and #PBMs, and you’ll see how insurance can create more obstacles to healthcare than it resolves(again while they have a good intention) . #communitypharmacy #Ontario #Healthcare

Exciting news from Bloomberg this week: Blue Cross Blue Shield Association (BCBS) is making Humira available to its California consumers with a $0 co-pay. This aligns with No Patient Left Behind's core belief: prescribed treatments should be available at low or no cost - that is what insurance premiums are for!   🔍 Key Takeaway: Why is this so rare? As Brian Reid explains in his incredibly valuable Cost Curve newsletter, BCBS achieved this by cutting out the middleman - Pharmacy Benefit Managers (PBMs). "Blue Shield isn't getting this deal because a PBM negotiated well. They're getting it by avoiding PBMs altogether."   This move challenges the traditional PBM model, which leads to higher costs and confusion for patients. BCBS's approach suggests a promising path forward: customers should seek greater value from their health plans by demanding they follow this blueprint.   💡 Question : How can we (employers, individuals, government) encourage more insurers to adopt this patient-first approach? Has anyone seen progress like this happening with other drugs, providers, or states? Let's continue pushing for a healthcare system where your insurance is there when you need it most. Share your thoughts below. #HealthcareReform #PatientAccess #NoPatientLeftBehind #InsuranceReform #CostPlusDrugs Read Cost Curve: https://lnkd.in/eyjFg89i

So, recently former FDA Commissioner Dr Scott Gottleib had this to say concerning PBMs and rebates. Click the bottom link for the recording. So let’s try to break this down. 💥Patient pays an inflated price or a copay percentage based on the drug’s full price, with with no rebate available to benefit their out of pocket expenses. 💥The drug maker gives a rebate to the PBM, which may or may not fully go back to the insurance provider to reduce the cost for the patient or the plan. (Because reporting is not transparent and there’s always an administrative holdback). 💥Insurance companies are suppose to use rebates to reduce plan cost of care events for companies and patients, and yet cost still continue to skyrocket. 🤔 Clear as mud. Got it. This is exactly the problem with GPOs. Where’s the evidence the rebates are used to reduce cost of care and billing offsets to patients, vs used as a side revenue model for hospitals? Are patients being billed at the full price of goods (often marked up for billing purposes), when the known percentage of rebates per item on contract are known by the hospital and billing department for every good or service on contract? There should be enough bribes, I mean “share backs”, in a ~$5-6 trillion healthcare product, services, or pharma spend to completely offset a great deal of care expenses, and yet all the players post billion dollar operating profits, and of course our premiums continue to rise, or worse, coverage is cut at the patient level. Seems enforcing Robinson-Patman should be implemented for critical goods and drugs to eliminate deceptive dynamic price discrepancies across state lines. One drug, one product, one price. Boom,🤯, middlemen issue solved. It’s complicated for a reason. Thanks No Agenda Show Nation!! #itm John C Dvorak and Adam Curry! Link: https://lnkd.in/dzzjZq6r

Attention All Ontario Healthcare Professionals and Stakeholders!! This initiative is supported by OnPharm-United Pharmasave Drugs and Box Labs The Ontario government is consulting the public on the critical issue of pharmacy choice. Insurance companies are forcing patients into Preferred Provider Networks (PPNs), limiting their ability to choose pharmacies and access personalized care. We need your support to protect patient rights and ensure equitable healthcare for all! Take Action Now: 1) If you are a healthcare provider in Ontario, Click the link below and sign the letter. 2) Please post the attached poster in your practice. 3) Patients can also submit their letter by scanning the QR code on the attached poster or clicking the link below. https://lnkd.in/gjA9Kkjv Deadline: October 22, 2024 Together, we can safeguard: Patient choice, Access to quality care and The sustainability of independent healthcare providers Please share and repost this with your networks! Let’s ensure that our voices are heard and that we continue to protect patient care and choice.

📣 Are you working with a #broker who knows how to navigate the pharmacy space? - You should be. ✅ If you are a Self-Funded group having an awful time with your current PBM relationship, I can help. 💊 SmithRx is a transparent, pass-through pharmacy benefits manager for self-insured employers. SmithRx operates independently from insurance companies and pharmacies so that their incentives are 100% aligned with the needs of their customers. SmithRx's cost savings programs connect members to the lowest cost drugs. 🔥 Modern PBM partnerships are changing the GAME!!! 📲 Let’s talk 469-833-6424 | Sarah Bahlman | INSURICA #dallas #advisors