PRIA Healthcare Management

PRIA Healthcare Management, founded in 2012 by Mike Simon, operates as a specialized patient access and reimbursement solutions company. Initially bootstrapped, the company secured a significant investment from Aldrich Capital Partners in January 2022 to expand its market access solutions and accelerate growth. This investment has supported the firm's expansion, including the acquisition of Argenta Advisors in October 2024 to diversify its service portfolio.

The firm's core business revolves around accelerating the market adoption of medical devices and procedures. PRIA partners with medical device manufacturers, from startups to established companies, as well as healthcare providers and organizations. The company's business model is centered on providing technology-enabled market access services. These services address the complexities of coding, coverage, and payment for new medical technologies. PRIA offers expertise in early reimbursement strategy, clinical trial reimbursement support, and managing patient-based appeals for denied care, aiming to ensure patients gain access to prescribed treatments. A key service is navigating the reimbursement process with public and private insurers to overcome coverage barriers, which is a critical step for the commercial success of new medical devices.

PRIA's services are designed to manage the entire reimbursement pathway, from supporting clinical trials to securing necessary coding for new devices. The company utilizes a data-driven approach and a proprietary patient-access portal to provide transparency and manage casework efficiently. This system facilitates communication between patients, providers, manufacturers, and insurers. By handling the complexities of reimbursement, PRIA enables medical device companies to focus on innovation while helping healthcare providers offer advanced treatment options. The company has demonstrated a high success rate, reporting a 10-year average of 73% for successful patient appeals.

Keywords: patient access solutions, healthcare reimbursement, medical device commercialization, market access services, reimbursement strategy, patient advocacy, insurance coverage, medical technology adoption, clinical trial reimbursement, prior authorization, medical billing support, healthcare consulting, MedTech reimbursement, patient appeals, denied care, healthcare market access, medical device reimbursement, patient support programs, healthcare finance, insurance navigation