Who’s Paying for It?

Reimbursement as a Marketing Strategy

Reimbursement is the ultimate gatekeeper in healthcare. Scaling prematurely, especially without reimbursement, can be an expensive mistake. Brent learned this first-hand: "I’ve tried to take sales forces out to market with non-reimbursed technology. And it’s difficult. It’s very difficult." Chasing adoption without reimbursement burns through resources, leaving you with little to show for it. Although Nociscan has completed more than 1,300 commercial cases to date through a cash pay model, Brent is focusing on building a reimbursement strategy instead of prematurely scaling a sales team. 

"Reimbursement requires evidence. You’ve got to create evidence to bring to the payers," Brent emphasizes. Payers won’t care about your pitch until you show them credible, compelling evidence that your technology improves outcomes and/or lowers costs. That’s why you need to invest early in clinical trials and other validation efforts. For Aclarion, this includes a national randomized control trial led by Johns Hopkins. “Those things take time, money, and investment,” Brent explains. “And we’re putting our money there instead of hiring sales reps in New Jersey, for example.” 

Brent and his team interviewed major payers in the United States to understand what Aclarion needed to secure reimbursement. They learned that until Aclarion had a few published, peer-reviewed clinical studies to support the adoption of their technology, the discussion was a non-starter.  “Your technology must at least demonstrate efficacy equivalent to the gold standard, and ideally, show improved outcomes—that’s the true benchmark. You also need a few studies, or at least one well-designed, foundational study, that clearly highlights the economic impact of adopting your technology on a broad scale, Brent emphasizes.” To support this, Aclarion commissioned a healthcare economist to run the Independent Economic Value Analysis of Low back pain (EVAL) study. The EVAL study findings project significant cost savings for the healthcare system. 

Proving the viability of your solution is a lifelong endeavor for a medtech company. “The need doesn’t end once you secure payer support,” Brent notes. Physicians across the adoption curve—especially those resistant to change—still need to be convinced. As Brent puts it, “You need to have it in your DNA."    

In Brent’s experience, the right voices matter. "The payers don’t really care when I call them," he admits, "but they do care when our list of KOLs call them." Key opinion leaders (KOLs)—respected physicians and researchers—can open doors. Experts on your side are more successful in engaging medical directors. To strengthen their approach, Aclarion has also brought on Jay Labine, MD, a former medical director of Priority Health in Michigan. Dr. Labine leverages his firsthand experience in payer decision-making to guide strategy and lead conversations with insurers. As part of Aclarion's small, focused team, he integrates feedback from the team, refines it, and uses it to effectively engage payers. While the company is still working toward reimbursement in the U.S., Brent is confident they are making meaningful progress. 

And finally, Brent advises, “Be disciplined." Ensure the market is ready for your product before hiring a salesforce or pushing for rapid adoption. It’s not glamorous, but it’s smart.

Know the Problem, Know the Players

Reimbursement isn’t the whole puzzle. Innovation is exciting, but in medtech, it only matters if it solves a specific problem and is positioned correctly.

With Nociscan, Brent is aiming for a standard-of-care scenario. “When you come in with chronic low back pain, you’re going to get a Nociscan because that’s going to inform all sorts of treatment plans and decisions going forward.” If he can position it as a standard of care, Nociscan will be the go-to solution for patients in the massive chronic lower back pain treatment market.

So, framing your product as essential—not optional—can be a game-changer for adoption. But for that to happen, Brent emphasizes, “foundational, rock-solid science needs to be in place.”

To create a seamless solution, you need to identify a gap. But gaps in healthcare are rarely straightforward. If you’re not an expert in your niche, it’s crucial to build close relationships with those who are.

Brent’s engagement with KOLs has been invaluable in this regard. “You have to develop real, intimate relationships with your key opinion leaders. Listen intently to the problems they face. They’ll tell you if you just ask the questions and listen,” he advises. Brent adds, “Understand the nuances of how and why your customers make their decisions relative to the technology you're trying to bring forward and really hone in on that and spend time developing that value proposition message with them.” 

Involve end-users early in the development process—even co-create with them. This ensures your product aligns with practical needs, addressing real issues rather than adding unnecessary complexity. That’s how you create something indispensable, not just interesting.