Behind the Strategy: An Expert’s Perspective

As we enter 2025, the MedTech industry is poised for significant transformation. Two key areas expected to drive growth are robotic surgery and artificial intelligence (AI), which are garnering increasing attention from investors, clinicians, and innovators. However, while these technologies hold immense promise, a critical challenge remains: the absence of separate reimbursement pathways, such as new codes or distinct payment categories. Instead, these innovations must navigate existing reimbursement frameworks, making market access and evidence generation essential for their adoption. Demonstrating their value through proof, rather than a mere proposition, is paramount.

Let’s examine these trends and explore the reimbursement and market access insights shaping their trajectory in 2025 and beyond.

Robotic Surgery: Scaling Accessibility

Robotic surgery has been a hot topic in MedTech for over a decade, with Intuitive Surgical’s DaVinci robot leading the way. While Intuitive has established itself as the market leader, competition is intensifying. Established players like Medtronic, as well as newcomers such as CMR Surgical and Moon Surgical, are entering the market. Though the initial capital investment for robotic systems remains high, the focus on value-based care is shifting the conversation toward cost efficiency and improved patient outcomes.

Reimbursement Considerations and ROI: For robotic surgery, there often isn’t a case for separate or higher reimbursement, as the robotic assistance is an integral part of the procedure. However, provider stakeholders are demanding that the clinical and economic value is established. So, the play is value proof vs. a value proposition.

“Hospitals are looking for solutions that demonstrate clear economic and clinical value,” says Michael Turner, a leading MedTech venture capitalist. “This means manufacturers must present strong health economic data showing reduced procedure times, shorter hospital stays, and improved recovery metrics.”

Investors are increasingly drawn to robotic systems designed for specific procedures, such as orthopedics or cardiovascular interventions and these niche focused specialty areas will come with a requirement of the clinical and economic value proof.

Artificial Intelligence: Beyond Buzzwords

Artificial Intelligence (AI) continues to dominate headlines, but in 2025, the focus has shifted from broad claims to tangible applications, especially in healthcare. Decision-support systems, predictive analytics, and imaging tools are among the most impactful uses gaining traction.

Market Access Challenge: While the FDA has led the charge for establishing streamlined pathways for software as a medical device (SaMD), the Centers for Medicare and Medicaid Services (CMS) and other third-party payers have lagged behind. Although these technologies show tremendous promise in diagnosing and treating health conditions, CMS still does not acknowledge them under a specific benefit category, thus, making it difficult to assess their proof of value and subject to a reimbursement pathway where new coding and payment methods may not apply or without a straightforward path. Oftentimes, reimbursement for these technologies is bundled into an existing service. Furthermore, the data required to secure “positive” payer coverage requires significant data, or proof as published in peer reviewed studies and/or through studies that rely on real-world evidence, however, without a separate coding mechanism or reimbursement pathway, it’s often difficult to assess and develop the necessary value proof.

One promising area is AI-powered diagnostics, particularly in oncology and rare diseases. Here, payers are beginning to recognize the value of earlier and more accurate diagnoses, which can reduce long-term treatment costs. However, demonstrating ROI remains critical to gaining widespread adoption.

Investment Considerations for 2025

Understanding the interplay between innovation and market access is more critical than ever. Here are a few takeaways to keep in mind:

A Solid Reimbursement and Market Access Strategy is Top of Mind for Investors: Companies with robust reimbursement and market plans, including evidence generation to demonstrate the value proof in clinical and health economic studies, are a critical imperative.

Regulatory Alignment is Key: Streamlined FDA pathways don’t always translate to immediate payer acceptance. Bridging this gap requires proactive planning and data generation.

Specialization Wins: Technologies addressing specific clinical or procedural gaps often face fewer market access hurdles and offer clearer value propositions.

A Final Word

The MedTech landscape in 2025 is brimming with opportunity, but success hinges on more than just innovation. Reimbursement and market access are critical levers that can make or break a technology’s commercial viability. As investors and stakeholders navigate this dynamic environment, staying informed and engaged will be the key to unlocking the potential of tomorrow’s MedTech giants.