Philip Macdonald Email & Phone Number

Provide executive level consulting for start-ups and mid-stage medical device, diagnostics, imaging, companion diagnostics and biotech companies for US and international markets. Emphasis is on providing key strategies supporting market access, reimbursement, coding and valuation, pricing, product/service line development, contracting, health policy and economics, and government affairs activities. This also includes assisting with regulatory filings specific to Breakthrough Device designation, submitting applications for new technology add on payment (NTAP) and transitional pass-through (TPT), and managing commercial launches for devices awarded NTPA and TPT status. Strategies are aligned with an organization’s Research & Development, Clinical, Marketing, and Sales objectives for purposes of effective market product placement. Portfolio of clients include companies in Gastroenterology, Cardiology, Surgery, Imaging, Ear/Nose/Throat, and Oncology, including respective AI applications.

Aliso Viejo, Ca, Us

Redmond, Wa, Us

Pricing strategy, reimbursement accomplishments that also include successfully gaining higher reimbursement levels by CMS (e.g., 93% increase for hospital outpatient payment), numerous coverage and market access accomplishments with national and regional payers (over 130M covered lives gained, including 100% Medicare MAC coverage), provider and payer economic modeling, new technology lifecycle management (pre/post-market). Health policy influencing, including CMS (national/MACs), medical societies and advocacy groups. Procedure coding and coding application expertise with AMA CPT categories I and III. Acquisition due diligence proficiencies: coding, coverage, payment per type of modality, delivery setting(s) and market acceptance.

Minneapolis, Mn, Us

Steward leadership of all healthcare economics, health policy and reimbursement strategies specific to all products and their franchise for all regions, globally. Focus was heavily driven by joint strategic planning and goal-setting with each franchise, facilitated by overseeing proactive implementation of required clinical and economic endpoints for purposes of market access opportunities, both in the US and OUS. Other responsibilities included new product development review, Phase 0 to IV, for optimum market launch opportunities with various country-specific payers and providers; acquiring from the AMA a Category III HCPCS code for measurement purposes, healthcare economic modeling development, including cost opportunity assessments for various delivery settings/countries; provider C-suite support bound by all regulatory compliance parameters; and M&A business plan due diligence. Leadership position was eliminated due to acquisition of company.

Baltimore, Maryland , Us

Provided leadership on Siemens’ business issues related to movements by public and private payer environments, health policy developments at federal and state levels, and international guidance where market access approaches are required. This involved independently reviewing and developing healthcare economic and reimbursement strategies associated with current and proposed legislative, regulatory and private sector market changes. Product responsibilities covered imaging and laboratory diagnostic businesses ($4.7B/€3,6B revenues).

New York, Ny, Us

Responsible for initiating a Healthcare Economics practice for firm. This practice assisted hospitals in addressing health reform requirements, specifically cost-effectiveness strategies. Also responsible for providing strategic guidance for providers in the areas of service line planning and management; physician alignment; M&A; and governance and organizational structuring.

Abbott Park, Illinois, Us

Responsible for providing support to internal and external customers with respect to healthcare economics, coverage and reimbursement, prevalence/operational modeling, and public and private policy impact analyses associated with products as aligned with customer margins. Additionally, assisted with annual five year strategic planning per product division; M&A due diligence; new technology development reviews; product/provider financial modeling; international reimbursement and healthcare economics support, including justifying products for cost-effectiveness and/or budget neutral impacts for country states; and pre/post-marketing clinical/economic data development that supported providers' interest in capitalizing on value-based purchasing arrangements.

Responsible for safeguarding the global diagnostic business while concentrating efforts on better product placement and coding/coverage/payment strategies of respective Bayer portfolio primarily with CMS, state Medicaid programs, private payer groups and the American College of Pathology. Secured from AMA a Category I CPT code from AMA. Successful in gaining coverage for the code by papers by implementing and managing multi-site studies to help with such efforts. AdvaMed liaison for Bayer, including Hill and state house affairs work through out US. Earlier role including Corporate Accounts responsibilities.

Nashville, Tn, Us

Responsible for projects specific to clinical improvements: lower costs and enhanced economic and clinical outcomes by means of care algorithms, managed care applications and educational initiatives. Active collaboration involved HCA medical advisory boards, pharmaceutical and diagnostic organizations. External Consultant: pharmaceutical and diagnostic delivery engineering for R&D products. Internal Consultant: Diabetic Task Force; Data Warehouse; Competitive Reconnaissance. Project unrelated to position: market analysis for Planning department centered on development of an acquisition process for leasing or purchasing Academic Medical Centers. Position and half of corporate were eliminated due to Department of Justice's action on HCA for improper upcoding.

Doctorate, Healthcare Management & Economics

Masters, Health Services Administration

Bachelors, History; Political Science