Hack the System: Inside the Medtech Money Maze

Notes:

[00:00:39] Saul Marquez: today I want to introduce our amazing guest. His name is Mark Miller. He’s a seasoned market access leader with nearly 30 years of experience driving adoption and reimbursement for breakthrough medical technologies across 20 clinical specialties. He’s an expert in this area. He’s a former Army infantry officer and a three-time Ironman triathlete. Mark now leads health economics and market access at Lumicell, where he helps bring novel cancer detection innovations to market.

[00:04:07] Saul Marquez: you’re leading health economics and market access at Lumicell, a company that’s tackling one of the toughest problems in cancer surgery today. What’s the market access strategy behind a technology that doesn’t fit neatly into an existing code or a care pathway?

[00:04:29] Mark Miller: I believe that it has taken me all these years to be able to see this from the big picture, because it’s a drug device combination. I mean, I can’t go into a lot of the details, or I’d have to read you our safety information over the phone. So, let’s just say we have a drug and a device combination, which makes it immediately complicated. We have a drug that identifies the procedure that’s done, but the drug is infused 2 to 6 hours before the procedure starts, and the whole intention is to allow that physician to scan the cavity before the lumpectomy procedure is completed to identify any cancer that remains in there. So, what I do is educate a lot of major medical centers, from MD Anderson, Mass General, that we’re starting at to make sure that they understand that the coding complexity of a drug and a device, and there are two separate ways to go about it. What’s also exciting is that we were awarded transitional pass-through payment from CMS as being a breakthrough or novel technology. So, a lot of things were done very well before I arrived. But it’s been a lot of work making sure medical centers and physicians understand this complex billing and coding situation.

[00:05:47] Saul Marquez: walk us through how you think about really building economic value stories that resonate with payers, providers, and investors, especially in the early stage of innovation.

[00:06:11] Mark Miller: I look at it in six elements. A lot of people look at market access to health economics, what my role is around the code, the coverage, and the payment. So, three things. They think, oh, what is the code that represents this procedure or drug. What’s the payment? What will be reimbursed? And what does the insurance company, does it cover it or doesn’t it? But they forget about the other three. And the other three elements are around clinical evidence, the health economics around it. Does this particular procedure or the drug or procedure that you work on? Does it ensure or help to ensure the patient doesn’t come back to the office or come back for more surgeries? Does it reduce costs? And then the sixth key element that really holds it all together is advocacy, is developing not only just advocates, but champions for your product. And that would be individuals that were in your clinical studies, individuals that are at medical centers that are adopting your technology, that are willing to stand up to insurance companies into their own administrative staffs, that they’re in health systems to have this technology adopted there. So, it’s really these six elements. And a lot of people feel, you know, it’s limited in these three. It really encompasses all together.

[00:07:28] Saul Marquez: If everybody listening had this playbook, how much faster could they move?

[00:07:53] Mark Miller: They would learn so much faster. I’ve been with a number of companies, you know, my career, you’ve seen it on my resume, and it’s true. We’re, used to be a long time ago, 15, 20 years, we were really late to the party. They wouldn’t hire somebody like me. There was damage already done. There was no evidence developed. There was no idea of what that code. And then a lot of people like me and my career would have to come in and try to repair that. The best thing is to start early, 18 months to two years ahead of time, working with the clinical medical affairs to build evidence, working with the Kols that are doing studies to build a network of advocates that support, and then finding out what is that story around economics, right? The other part, not to say they’re easy, but they play out. You can get a code, you can get a payment, and you can work on coverage, but without the other three, it doesn’t hold it together. It doesn’t support it.

[00:08:50] Saul Marquez: where do startups most often stumble when it comes to pricing, reimbursement, or market entry planning?

[00:09:21] Mark Miller: We talked a bit a moment about it not starting early enough. They’ll have a sales leader, they’ll have a CEO, maybe an operations person, a marketer, before they would have a market access individual that should be hired at the same time. So, we can get started on building this story around the economics and around the coding. And also what they don’t understand is that the earlier start, you can have conversations with CPT editorial panel before having submissions early on, earlier than you expected, getting feedback from the staff on your coding application. There’s a lot of things you can do earlier. Many of these companies will wait too late, and then they have to figure it out and kind of fill in the gaps in their story later than they should have started. So, I would say just the earlier they start as far as this dialogue between, obviously, they start with FDA, but starting with CPT editorial panel and figuring out where you fit within the coding book is very important also.

[00:10:24] Saul Marquez: What are some of the clinical or economic drivers that consistently open doors with payers regardless of specialty?

[00:10:41] Mark Miller: Yeah, it comes back to identifying what the standard of care is. And do you approve improve upon the standard of care? We’re a young company and I’ve been with other companies, don’t have a lot of data, and I talk to them even during my interviews at my recent company, is that as soon as you have evidence, as soon as you get approval, you should be starting those new studies, trying to develop more of your literature base so you can go to the payers with a lot of evidence to say that we’re improving upon standard of care. We’re changing standard of care. And then the final element is that one of those six points I made earlier is the economics. Does this add costs for a reason? Does it add legitimate costs that are important because they reduce readmissions or re-incision rates in the situation as a breast cancer or another type of cancer? Does the patient not have to come back a second or third time to have more cancer removed? So these types of things are important to a payer. I mean, they are as clear as they can be with what their policies dictate, but there is most of the time, you’re not starting in a market that hasn’t or doesn’t already have a, you know, a care pathway. So, you have to show your drug or your procedure compared to that traditional standard of care.

[00:12:20] Mark Miller: 15, 20 years ago, we were doing roadshows for physicians to educate them on the levers in DC, the levers with an insurance company who you need to talk to, and how you would frame your story. The key component of advocacy is identifying those individuals that want to support your product. A lot of people say, love it, I’ll use it, but they’re really not willing to take time out of their lives to defend it in public. You know, maybe one-on-one, peer-to-peer with an insurance company, going to DC and talking to legislators about policy there, or talking to CMS. So, those are the individuals that are the top, the cream of the crop for advocates and also helping them understand how that argument and how that story needs to be translated, because a lot of times, a physician, I like to say it this way, is that coverage, medical policy is really a result of what physicians are willing to accept. So, if the policy is restrictive for a physician and they walk away, well, that’s just an indicator to the payer that their policy works, right? But if you truly believe in the procedure or the drug, you’re willing to say, this is why I believe we should change this policy, and they’re willing to have those one-on-one discussions.

[00:13:51] Saul Marquez: What do you wish more medtech CEOs understood about timelines and influence levers in those arenas?

[00:14:04] Mark Miller: Everything’s public, first of all. I mean, I’ve been hired as a consultant in the past, and I clearly show them everything that’s available on the internet on CMS website. What they’ll be surprised to find is that the earlier you start, the better. Like a lot of things, you can have an application into the CPT editorial panel with limited data. Look for either it’s a category three code, most likely not a category one right out of the gate, and you’ll get feedback. I’ve felt at a very positive experience with the CPT editorial panel and the staff when I’ve had to interact with them. They give you positive or negative feedback, but it’s clear feedback on your application, and then you have a chance to withdraw it. There are three meetings every year, and they all lead to either a committee if it’s a category one or not, but you have a chance to withdraw. So, if you feel your success rate is pretty limited, you would withdraw it and go to the next meeting. But to not start early enough and try the process and have a conversation would be a big mistake in early startup companies.

[00:15:16] Saul Marquez: What trends in policy payment reform or clinical evidence generation are you keeping an eye on in 2025 and beyond?

[00:15:36] Mark Miller: for the last few years has been this artificial intelligence AI, and many products claim to be AI. Artificial intelligence are not, it has to actually do some computer learning, machine learning with data sets. So, there is a high bar to truly being an AI. But even in that, with that high bar, I think what’s falling behind, I’ve noticed, is that CMS has not dedicated codes that actually appropriately reimburse for the innovation that would be linked to AI. I mean, I worked, and this is a few years ago in San Diego with a company that doesn’t exist anymore, actually, in the United States doesn’t. But, and we found the link verse at that time, there was a small company I was at that ended up being GI Genius for Medtronic. And GI Genius is a blockbuster artificial intelligence product. And you could talk to somebody at Medtronic about it, but it basically helps a physician identify polyps within the colon during a colonoscopy that they couldn’t see with their own eyes. Many of the physicians were concerned that, oh, I can see all of them. But no, they were missing. And this technology is out there today, and a lot of other cancers we’re going to see. I’m to answer your question, is that HOPE CMS, and I would love to have a conversation with them to figure out how to make sure that those types of technologies are appropriately coded and reimbursed so they stay within the continuum of care, right?

[00:17:35] Saul Marquez: You’ve done Ironman triathlons. You’ve led soldiers. How have those experiences shaped your leadership style and high-stakes regulated industries like healthcare?

[00:18:02] Mark Miller: it really comes down to just being able to be comfortable in an uncomfortable environment.

Transcript:

[00:00:06] Martin Cody: Welcome to The Edge of Healthcare, where the pulse of innovation meets the heartbeat of leadership. Tune in to gain exclusive access to strategies, experiences, and groundbreaking solutions from influential payer and health system leaders. This isn’t just a podcast, it’s your VIP ticket to the minds shaping the future of healthcare right now. Buckle up, subscribe, and get ready to ride to The Edge of [00:00:30] Healthcare, where lessons from leaders are ready for you to use today.

[00:00:39] Saul Marquez: Hello everyone, and welcome back to the Edge of healthcare, where bold ideas meet real-world impact. I’m Saul Marquez, CEO of Outcomes Rocket and the host of the Outcomes Rocket podcast, guest-hosting this series. Martin Cody has transitioned from the podcast, and I want to give him a shout-out for the many episodes he’s done [00:01:00] to get you The Edge in Healthcare. While Martin’s no longer hosting episodes and insights from healthcare’s best leaders will continue. So, if you’re looking for those insights, you’re in the right place. And with that, today I want to introduce our amazing guest. His name is Mark Miller. He’s a seasoned market access leader with nearly 30 years of experience driving adoption and reimbursement for breakthrough medical technologies across 20 clinical specialties. [00:01:30] He’s an expert in this area. He’s a former Army infantry officer and a three-time Ironman triathlete. Mark now leads health economics and market access at Lumicell, where he helps bring novel cancer detection innovations to market. Mark, welcome to the podcast! So glad you could join us.

[00:01:49] Mark Miller: Hey, nice to meet you. Thanks for having me.

[00:01:51] Saul Marquez: It’s a pleasure. Hey, listen, did I leave anything out of your bio that maybe you want to share with our listeners and viewers?

[00:01:57] Mark Miller: I mean, I think I would add is that it just seems like, you know, typically [00:02:00] someone coming from the military or from a military background school. I went to West Point, wouldn’t end up in a market access or health economics role, right? And it really wasn’t in my future. I did at the time, but it was just a fortunate set of circumstances that placed me in one of my first jobs back in the 90s and happened to take on this role, but it was called managed markets at the time, and it wasn’t even market access or health economics. It was just really a new [00:02:30] role within pharma and medtech. So, I got lucky with it, and it’s been just a 30-year journey. It’s been exciting.

[00:02:36] Saul Marquez: That’s fantastic, Mark. Well, thank you for your service. Appreciate what you’ve done for our country, and it’s great to have minds like yours in healthcare to solve the problems we have. So, you’ve had a remarkable career, as you said, spanning from pharma to medtech, VC, and now surgical oncology at Lumicell. What throughline connects all your work, and what still gets you fired up about market [00:03:00] access after 30 years?

[00:03:01] Mark Miller: Yeah, I think the exciting thing about it, and that’s what excited me from the point in 1997 when they took on my first account manager job, where I was able to call on Blue Shield of California, some of the biggest payers in the region at the time, living in California, is that I was able to fill in the gaps for the representatives and the organizations that I supported around what’s going on at this insurance company. What is the payment? What’s the code? What’s the reimbursement [00:03:30] and coverage around a particular technology? And that started off in oncology, and now I’m 30 years back to oncology, where I started. At that point, I was really at the time, one of the original Daiichi pharmaceutical representatives, one of the first ten people. We were splitting off and growing, and they needed to managed markets person. At the time, it was a little disappointed that I got the managed markets role. I wanted the sales leadership role, but it was the best thing that ever happened to me. Once I started [00:04:00] down that road. I’ve been basically in all the different various elements of market access for the last 30 years.

[00:04:07] Saul Marquez: It’s amazing. Well, God works in mysterious ways, and he certainly paved that career path of yours. And so, you’re leading health economics and market access at Lumicell, a company that’s tackling one of the toughest problems in cancer surgery today. What’s the market access strategy behind a technology that doesn’t fit neatly into an existing code or a care pathway?

[00:04:29] Mark Miller: Yeah, it is [00:04:30] very unique, and that, I believe that it has taken me all these years to be able to see this from the big picture, because it’s a drug device combination. I mean, I can’t go into a lot of the details, or I’d have to read you our safety information over the phone. So, let’s just say we have a drug and a device combination, which makes it immediately complicated. We have a drug that identifies the procedure that’s done, but the drug is infused 2 to 6 hours before [00:05:00] the procedure starts, and the whole intention is to allow that physician to scan the cavity before the lumpectomy procedure is completed to identify any cancer that remains in there. So, what I do is educate a lot of major medical centers, from MD Anderson, Mass General, that we’re starting at to make sure that they understand that the coding complexity of a drug and a device, and there are two separate ways to go about it. What’s also exciting is that we [00:05:30] were awarded transitional pass-through payment from CMS as being a breakthrough or novel technology. So, a lot of things were done very well before I arrived. But it’s been a lot of work making sure medical centers and physicians understand this complex billing and coding situation.

[00:05:47] Saul Marquez: Yeah, no. Thanks so much for sharing that. And I know there’s a lot of device entrepreneurs out there struggling to find that payment fit. And so, for our listeners not steeped in reimbursement, [00:06:00] walk us through how you think about really building economic value stories that resonate with payers, providers, and investors, especially in the early stage of innovation.

[00:06:11] Mark Miller: Yeah, I look at it in six elements. A lot of people look at market access to health economics, what my role is around the code, the coverage, and the payment. So, three things. They think, oh, what is the code that represents this procedure or drug. What’s the payment? What will be reimbursed? And what does the insurance [00:06:30] company, does it cover it or doesn’t it? But they forget about the other three. And the other three elements are around clinical evidence, the health economics around it. Does this particular procedure or the drug or procedure that you work on? Does it ensure or help to ensure the patient doesn’t come back to the office or come back for more surgeries? Does it reduce costs? And then the sixth key element that really holds it all together is advocacy, is developing not only just advocates, [00:07:00] but champions for your product. And that would be individuals that were in your clinical studies, individuals that are at medical centers that are adopting your technology, that are willing to stand up to insurance companies into their own administrative staffs, that they’re in health systems to have this technology adopted there. So, it’s really these six elements. And a lot of people feel, you know, it’s limited in these three. It really encompasses all together.

[00:07:28] Saul Marquez: Mark, I love that perspective, right? And [00:07:30] I’m a huge fan of frameworks. You know, when you have a solid framework, it gives you reproducibility. And after 30 years of doing this, I think you’ve distilled it to a very clear one. It’s code, it’s coverage, it’s payment evidence, health economics, and advocacy. If everybody listening had this playbook, how much faster could they move?

[00:07:53] Mark Miller: You know, it’s true. They would learn so much faster. I’ve been with a number of companies, you know, my career, you’ve seen it on my resume, and it’s [00:08:00] true. We’re, used to be a long time ago, 15, 20 years, we were really late to the party. They wouldn’t hire somebody like me. There was damage already done. There was no evidence developed. There was no idea of what that code. And then a lot of people like me and my career would have to come in and try to repair that. The best thing is to start early, 18 months to two years ahead of time, working with the clinical medical affairs to build evidence, working with the Kols that are doing studies to [00:08:30] build a network of advocates that support, and then finding out what is that story around economics, right? The other part, not to say they’re easy, but they play out. You can get a code, you can get a payment, and you can work on coverage, but without the other three, it doesn’t hold it together. It doesn’t support it.

[00:08:50] Saul Marquez: Well said, well said. Well, there you have it, folks, by the way. Like you’ll listen to the rest of our podcast, but in the show notes, you’ll find ways to get in touch with Mark. Oftentimes, [00:09:00] we have such great discussions, tip of the iceberg, things like this that could be unpacked so much further. That’s what follow-up is for, and we always encourage that with our guests. If you’re a listener, that’s something resonates, make sure you do that. So, Mark, in your experience, where do startups most often stumble when it comes to pricing, reimbursement, or market entry planning?

[00:09:21] Mark Miller: Yeah, I think they stumbled. We talked a bit a moment about it not starting early enough. They’ll have a sales leader, they’ll have a CEO, maybe an operations person, [00:09:30] a marketer, before they would have a market access individual that should be hired at the same time. So, we can get started on building this story around the economics and around the coding. And also what they don’t understand is that the earlier start, you can have conversations with CPT editorial panel before having submissions early on, earlier than you expected, getting feedback from the staff on your coding application. [00:10:00] There’s a lot of things you can do earlier. Many of these companies will wait too late, and then they have to figure it out and kind of fill in the gaps in their story later than they should have started. So, I would say just the earlier they start as far as this dialogue between, obviously, they start with FDA, but starting with CPT editorial panel and figuring out where you fit within the coding book is very important also.

[00:10:24] Saul Marquez: Start early, folks. Start early. Appreciate that, Mark. And so, you’ve supported technologies in your [00:10:30] many years across oncology, neurology, urology. And now you’re back at oncology. What are some of the clinical or economic drivers that consistently open doors with payers regardless of specialty?

[00:10:41] Mark Miller: Yeah, it comes back to identifying what the standard of care is. And do you approve improve upon the standard of care? We’re a young company and I’ve been with other companies, don’t have a lot of data, and I talk to them even during my interviews at my recent company, is that as soon as you have evidence, as soon as you get approval, [00:11:00] you should be starting those new studies, trying to develop more of your literature base so you can go to the payers with a lot of evidence to say that we’re improving upon standard of care. We’re changing standard of care. And then the final element is that one of those six points I made earlier is the economics. Does this add costs for a reason? Does it add legitimate costs that are important because they reduce readmissions [00:11:30] or re-incision rates in the situation as a breast cancer or another type of cancer? Does the patient not have to come back a second or third time to have more cancer removed? So these types of things are important to a payer. I mean, they are as clear as they can be with what their policies dictate, but there is most of the time, you’re not starting in a market that hasn’t or doesn’t already have a, you know, a care pathway. So, you have to show your drug or your [00:12:00] procedure compared to that traditional standard of care.

[00:12:04] Saul Marquez: That’s great. And it goes back to the health economics and the evidence, right? That’s right. Fourth and fifth pillars that you shared. And I was really intrigued by your idea of advocacy, right? Like getting your KLLs in order. If you don’t do that way ahead of time, you’re missing out.

[00:12:20] Mark Miller: Oh, so much so. I mean, I remember the days where we would help organize these physicians. They didn’t understand how to interact with payers. So, 15, 20 [00:12:30] years ago, we were doing roadshows for physicians to educate them on the levers in DC, the levers with an insurance company who you need to talk to, and how you would frame your story. The key component of advocacy is identifying those individuals that want to support your product. A lot of people say, love it, I’ll use it, but they’re really not willing to take time out of their lives to defend it in public. You know, maybe one-on-one, [00:13:00] peer-to-peer with an insurance company, going to DC and talking to legislators about policy there, or talking to CMS. So, those are the individuals that are the top, the cream of the crop for advocates and also helping them understand how that argument and how that story needs to be translated, because a lot of times, a physician, I like to say it this way, is that coverage, medical policy is really a result of what physicians are willing to accept. So, if [00:13:30] the policy is restrictive for a physician and they walk away, well, that’s just an indicator to the payer that their policy works, right? But if you truly believe in the procedure or the drug, you’re willing to say, this is why I believe we should change this policy, and they’re willing to have those one-on-one discussions.

[00:13:51] Saul Marquez: That’s great, Mark, really insightful. You’ve personally worked with CMS and the AMA CPT panel. What do you wish more medtech CEOs understood about [00:14:00] timelines and influence levers in those arenas?

[00:14:04] Mark Miller: Yeah, I think they would. Everything’s public, first of all. I mean, I’ve been hired as a consultant in the past, and I clearly show them everything that’s available on the internet on CMS website. What they’ll be surprised to find is that the earlier you start, the better. Like a lot of things, you can have an application into the CPT editorial panel with limited data. Look for either it’s [00:14:30] a category three code, most likely not a category one right out of the gate, and you’ll get feedback. I’ve felt at a very positive experience with the CPT editorial panel and the staff when I’ve had to interact with them. They give you positive or negative feedback, but it’s clear feedback on your application, and then you have a chance to withdraw it. There are three meetings every year, and they all lead to either a committee if it’s a category one or not, but you have [00:15:00] a chance to withdraw. So, if you feel your success rate is pretty limited, you would withdraw it and go to the next meeting. But to not start early enough and try the process and have a conversation would be a big mistake in early startup companies.

[00:15:16] Saul Marquez: Yeah, great call out, man. There’s so much gold in this episode, folks. We could turn this into an e-book. It’s so good. Looking ahead, you know, let’s talk policy. What trends in policy [00:15:30] payment reform or clinical evidence generation are you keeping an eye on in 2025 and beyond?

[00:15:36] Mark Miller: I think you know as well as I do that’s the buzzword today. And for the last few years has been this artificial intelligence AI, and many products claim to be AI. Artificial intelligence are not, it has to actually do some computer learning, machine learning with data sets. So, there is a high bar to truly being an AI. But even in that, with that high bar, I think what’s [00:16:00] falling behind, I’ve noticed, is that CMS has not dedicated codes that actually appropriately reimburse for the innovation that would be linked to AI. I mean, I worked, and this is a few years ago in San Diego with a company that doesn’t exist anymore, actually, in the United States doesn’t. But, and we found the link verse at that time, there was a small company I was at that ended up being GI Genius for Medtronic. And GI Genius [00:16:30] is a blockbuster artificial intelligence product. And you could talk to somebody at Medtronic about it, but it basically helps a physician identify polyps within the colon during a colonoscopy that they couldn’t see with their own eyes. Many of the physicians were concerned that, oh, I can see all of them. But no, they were missing. And this technology is out there today, and a lot of other cancers we’re going to see. I’m to answer your question, is that HOPE CMS, and I would love to have a conversation with them to figure out how to [00:17:00] make sure that those types of technologies are appropriately coded and reimbursed so they stay within the continuum of care, right?

[00:17:07] Saul Marquez: Yeah. Great caller. And I actually spent eight years at Medtronic.

[00:17:11] Mark Miller: Oh, did you?

[00:17:11] Saul Marquez: Prior to my agency life, I did have a chance to see the product that worked. It’s actually quite impressive.

[00:17:17] Mark Miller: It is amazing. It really is. I saw it in its infancy. And then I was with a company, Cosmo Pharmaceuticals, that licensed it. So, that’s where my experience ended when I left that company and that they decided [00:17:30] to just, I think, work out of Italy from that point on, but it was based right out of San Diego.

[00:17:35] Saul Marquez: Awesome. It’s a small world. It’s a small world. Yeah. I really appreciate all the insights you’ve shared with us around having breakthrough devices, the process, the watch-outs, the recommendations. I want to shift to some of the personal side for you. You’ve done Ironman triathlons. You’ve led soldiers. How have those experiences shaped your leadership style [00:18:00] and high-stakes regulated industries like healthcare?

[00:18:02] Mark Miller: Yeah, I think underlying theme, too, for me, is really continuous improvement. Trying to, my life and even my consulting company was called River of Nickels, and I consider life a matter of small little nickels, small little incremental improvements or negative problems, issues going on that can multiply and become a very important improvement physically, mentally, [00:18:30] professionally. So, that’s the way I look at the Ironman is it was something I could put on the calendar, and the military was the same way. A very big uphill climb, a huge obstacle in front of me. But it was on the calendar, and I had to achieve something, and it kept me. I had some of my most productive years in this industry. When I was doing Ironmans, it was because I had to train up to that. I had to do a number of marathons before and half Ironmans to ultimately, [00:19:00] a year later, complete the full Ironman. So, it really comes down to just being able to be comfortable in an uncomfortable environment. And same with the military. I went to Ranger School, went to West Point, and nothing will make you feel like you can get along with others. We used to say cooperate and graduate is basically, you know, when you’re cold and hungry and wet and in the middle of nowhere, you lean on each other a lot. I think that has really prospered within [00:19:30] my life, dealing with companies, going through adversity, or trying to figure them get off the ground, being positive, and trying to ensure that, you know, you could easily take the negative path. And I take the positive try to anyway in my life.

[00:19:44] Saul Marquez: Hey, listen, I appreciate that. And you kind of brought a lot of visuals with your descriptions there. And I think there’s a reason they call this segment of device the Valley of Death. It’s true, it’s true, and it’s true.

[00:19:56] Mark Miller: You can look at my resume that it’s a pattern of starts [00:20:00] and unstarts, starts, and stops, and starts, and stops, and it just happens. And luckily, I’m old enough now that I’ll have to explain why I’ve been to so many different companies. Once people have been in the medtech industry, they realize that a lot of them just don’t make it. And that’s just the nature of the beast, right? And I enjoy it because it is an exciting venture to start off with. Nothing is here, and to create it from scratch.

[00:20:22] Saul Marquez: Yeah. And you know, and med device. I have a lot of respect for the folks in med device and pharma, just because it takes [00:20:30] a long time. But man, when you hit it, you could really make a huge impact on people, have a very successful business, and ultimately, makes it all worth it. So, thanks for sharing that, Mark. Super interesting. So, I’m going to conclude with one of Martin’s famous questions here. You’re stuck at an airport for four hours. Who in the healthcare space, past or present, would you want to grab a bourbon or a black coffee with, and what would you ask [00:21:00] them?

[00:21:00] Mark Miller: Yeah, I’m more of a coffee drinker. I’m a, you know, way too many coffees during the day. But I think Dr. Oz, you know, being the new CMS administrator, new to the role, clearly, you know, a very well-known doctor in the world of television, but also, you know, a very excellent cardiologist in his own right. But he’s, no way he could understand the complexities of the coding system and how, as you probably know it, depending on where you are in the United [00:21:30] States, codes make a difference in how much is reimbursed. Getting a procedure in the middle of Mississippi is different than getting into Palo Alto based on the hospital’s reimbursement. So, these are things that I think over time we need to figure out in healthcare. It won’t happen overnight, but I would love to sit down with him and have a conversation.

[00:21:49] Saul Marquez: That’s awesome, Mark. Dr. Oz, if you’re listening to this one. Yeah, Mark is ready to have a chat with you. He’s got a lot of interesting perspectives, so I’d say take him up on it. [00:22:00] That’s fantastic, Mark, I think it’s a great opportunity where collaboration some of your insights over the last 30 years, you could add a lot of value to him and vice versa. This has been a ton of fun, Mark. If you wanted to share where people could get in touch with you and a closing thought, that would be a great way for us to conclude.

[00:22:20] Mark Miller: Sure, they can just reach out to me via LinkedIn, probably the easiest. Even my personal email address is on LinkedIn. It’s open, so feel to reach out to me there. I love working [00:22:30] with startup companies. I always enjoy the enthusiasm of new technology, and the possibility of helping a lot of patients is just exciting for me, especially as I get older. I’m not interested in the large pharma companies, so young small startup companies out there. I’m willing to help them out if they’re interested, but it’s been an exciting journey so far, and I’m not done yet, so I’m looking forward to the next, you know, 10, 15 years.

[00:22:54] Saul Marquez: That’s awesome, Mark. Well, thank you very much. And for everybody listening. Take Mark Miller up [00:23:00] on his invitation to connect. Now’s the time to reshape your business and have the edge. Really appreciate everyone joining us on The Edge of Healthcare, and I hope today’s conversation gave you that fresh perspective and real tools to apply in your work. For more episodes and show notes, and resources, you could check everything out on MadaketHealth.com. Until next time, keep pushing boundaries. Be bold, stay sharp, and Mark, thanks for being with us.

[00:23:27] Mark Miller: Thank you. I really appreciate it. Thank you very much.

[00:23:33] Martin Cody: Thanks [00:23:30] for diving into the edge of healthcare with us today. I hope these insights will fuel your journey in healthcare leadership. For more details, show notes, and ways to stay plugged in to the conversation, head over to MadaketHealth.com. Until next time, stay ahead of the curve with The Edge of Healthcare, where lessons from leaders are always within reach. Take care of yourselves, and keep pushing the boundaries of healthcare innovation.