MCRA and PearlDiver Technologies to offer claims-based analyses and reports using common coding by physicians

Aug 28 2009

Musculoskeletal Clinical Regulatory Advisers, LLC, the leading musculoskeletal consulting firm focused on regulatory, clinical, intellectual property, quality assurance and reimbursement strategy development, announced a strategic alliance with PearlDiver Technologies Inc., Fort Wayne, IN. The alliance will allow MCRA to enhance its analytical services and reports by leveraging PearlDiver’s historical orthopedics-related claims data from Medicare and commercial payors, clinical outcomes reported in peer reviewed publications and by combining the proprietary market intelligence of MCRA and PearlDiver.

MCRA and PearlDiver will now be able to offer claims-based analyses and reports using common coding by U.S. hospitals and physicians. Analyses range from basic reporting on specific procedures or treatments within an orthopedic-related condition, to advanced analyses including cost of care, treatment indices, market intelligence and trend reporting.

By combining historical claims data with proprietary knowledge, MCRA and PearlDiver will be able to offer greater depth to forecasts of future utilization of health care resources and market trends. The strategic alliance combines MCRA’s market leading talent in due diligence and strategy execution in orthopedics with PearlDiver’s pre-eminent medical database in the U.S. of what will soon be 500 million HIPAA-compliant patient records covering approximately 40 million unique patients..

Four reports are immediately available and may be customized to a client’s technology or niche focus. These reports include:

• Basic Reporting – Provides historical reporting on specific medical diagnosis or procedure codes. This report provides basic reimbursement information which is invaluable for executive, sales, marketing, and product development personnel, as well as regulators, distributors, hospital staff and procurement personnel.
• Reimbursement Utilization Report – Combines the above basic reporting with coding, utilization and analysis, as well as historical trends. Understanding the historical utilization of health care resources will allow executives to better manage business needs, and develop plans based upon data rather than anecdotal information.
• Reimbursement Utilization & Market Intelligence Report – Along with data reporting and detailed analyses, these reports provide a comprehensive review of the relevant clinical literature and longitudinal patient mapping, identification of market opportunities, and market estimation.
• Comprehensive Market & Reimbursement Valuation Analysis – Combines the above information with competitive profiles, market revenue and growth estimates, market pricing considerations, and regulatory, clinical, reimbursement, and intellectual property considerations. This report is invaluable for financial and strategic due diligence or new product development decisions.

“Future health care choices, technology development and investments will be based upon data and demonstrated clinical effectiveness by combining empirical data derived from public and private insurance payor databases with published clinical evidence and market expertise,” MCRA Vice President of Reimbursement Charles Schneider explained.

“MCRA and PearlDiver are in the best position to address recurring questions received by insurance carrier representatives, regulators, employer coalitions and technology innovators. As a result, this strategic alliance will further distinguish the two firms and their ability to provide meaningful counsel to our customers,” Schneider added.

“PearlDiver is quite pleased with the continued development of our internal capabilities as well as the growth of our professional relationships within the industry,” PearlDiver Co-Founder and CEO Robin Young noted. “This new agreement is good for MCRA, good for PearlDiver and great for our existing and prospective customers.”

MCRA General Manager David Lown added, “Executive leaders today demand up-to-date, comprehensive information within a multitude of disciplines to make decisions. This strategic alliance is designed to provide executives comprehensive data with expert analysis by leaders in the industry.”

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