Deborah Godes - McDermott+
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Overview

Deborah advises clients on reimbursement and policy strategy for medical devices, diagnostics, biologics and health services by public and private payers. With more than 25 years of health industry experience, Deborah leverages her deep knowledge and strong industry relationships to deliver strategic, operational and policy consultative services to companies of all sizes, from start-ups to Fortune 100 companies. Due to her deep background in working with clients across the healthcare services spectrum, Deborah has a detailed understanding of the market access process and the historical successes to help healthcare clients with emerging and innovative technologies achieve their goals.

For the past decade, Deborah has worked alongside healthcare innovators to advance their market access goals, including:

  • Navigating the complex Centers for Medicare and Medicaid Services (CMS) landscape;
  • Addressing the challenges and opportunities of bringing e-products to market; and
  • Providing insight on the US healthcare system and the health industry.

Deborah also collaborates with clients pursuing Medicare coding, coverage and payment of their groundbreaking, digitally-enabled healthcare solutions and services, including diagnostic tests and medical devices, artificial intelligence (AI)-powered technologies, remote monitoring tools, and other innovative health services. Her work encompasses assessing the various pathways in federal testing and the requirements needed to obtain additional or incremental payment. Deborah has been successful in obtaining favorable payment rates under the Medicare Clinical Laboratory Fee Schedule, incremental payment in the hospital inpatient and outpatient setting, and procedure, product and diagnosis codes.

Prior to joining M+, Deborah was a senior leader at a health technology company focused on the healthcare benefits industry. She also held roles at several consulting firms where she focused on corporate and product strategy for health plans launching new products in the private sector, built health economic models, and analyzed data to assess the effectiveness of federal and state health programs.

Deborah Godes

+1 202 204 1455

Education

  • Wharton Business School, University of Pennsylvania, M.B.A., Healthcare and Entrepreneurial Management, 2002
  • Princeton University, B.A., Politics, 1996

Representative Experience

  • Analyze Proposed and Final Rule changes to Medicare payment policies (e.g., Medicare Physician Fee Schedule, Outpatient Prospective Payment System, Ambulatory Surgery Center) and publicly available Medicare data (including payment, cost, and utilization data) to evaluate client strategies.
  • Develop budget impact models that assess the cost impact of proposed legislation on Medicare expenditures.
  • Model the impact of alternate payment methodologies for hospitals, laboratories and physician services.
  • Monitor local policies on coverage and payment for products and services and prepares issue memoranda for clients.
  • Analyze the broader adoption of technology and services on direct medical costs to patients and expenditures for payers.
  • Draft summaries and prepare analyses of legislative and regulatory developments of interest to our clients.

Publications

“Migrating to Consumer-Directed Healthcare: How to Achieve CDH at Your Organization’s Own Pace”, 28th Annual HR Florida Conference & Expo, September 2006

“Assimilating Health and Wealth: Frontline Perspectives on Employee/Consumer Behavior Influenced by CDH”, Next Generation Health Plan Banking & Administration Management, January 2008

Market Barriers to the Development of Pharmacotherapies for the Treatment of Cocaine Abuse and Addiction; Prepared for the Office of Health Policy, Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, September 12, 1997.

Then and Now: Health Plan Movement in the CDH Market; The Healthcare Savings Chronicle, February 2007.

Ten Steps to Implementing a Successful Consumer Directed Health Plan; Benefits and Compensation Digest, October 2007.