Advanced therapies, paid in a way the next patient can count on.

A CAR-T and advanced-therapy reimbursement practice.

HealthPulse Advisors helps hospitals, cancer centers and life-sciences companies evaluate payment arrangements, purchasing decisions and program economics for CAR-T and advanced therapies.

We evaluate these decisions from the treatment center's perspective: payment terms, cash timing and financial exposure.

Discuss a decision See selected work

Three decisions HealthPulse supports.

Accept, change or decline a payment arrangement

When to engage us: Hospitals and cancer centers evaluating payer contracts, single-case agreements or outcome-linked terms for advanced therapies.
What you receive: An assessment of the proposed terms, applicable payment rules, program costs and financial exposure, with assumptions and unresolved terms made explicit.

Hospitals and cancer centers

Expand a program or open a site

When to engage us: Health-system leaders and their advisers assessing the financial case for advanced-therapy expansion.
What you receive: A board-ready brief on payer pathways, directional economics and the evidence needed before committing to expansion.

Hospitals and cancer centers

Choose a payment and purchasing route

When to engage us: Life-sciences teams evaluating how purchasing and payment routes affect treatment-center economics.
What you receive: A comparison of the relevant routes and an editable model for testing payment, acquisition-cost and other agreed assumptions.

Life sciences

Selected work.

Client Assignment

Advanced-therapy expansion brief

Decision: Whether, and in which regions, a multi-state health system should expand its CAR-T and other advanced-therapy capacity. HealthPulse supported the advisory firm working with the health system.
Work delivered: Directional analysis of payer pathways and the financial considerations for regional expansion. The pathways ran from 340B-eligible outpatient care to Medicare Advantage.
Use: A board-ready investment brief in editable slides, for use in the board's own materials.

Client Assignment

Oncology payment and purchasing analysis

Decision: How purchasing routes compare under stated payment and cost assumptions, for a pharmaceutical company's oncology team deciding how its therapies are bought and paid for at treatment centers.
Work delivered: An analysis of each purchasing route against hospital payment rules, with every input traced to its source.
Use: Editable readouts for the client's leadership meetings, and an editable decision model for the client team to test scenarios.

University ContractUniversity of GeorgiaSelected provider under a campus-wide academic consulting contract.
Independent AnalysisPPS-exempt cancer-center reimbursementMedicare cost-based payment, the outpatient adjustment and CAR-T contract terms without a DRG anchor.
Independent AnalysisRural hospital payer economicsWhether recurring payer economics can sustain care once grant funding ends.

HealthPulse advises one side of a negotiation and says so. It never implies it represents all sides impartially.

All selected work and research

Research

HealthPulse AnalysisOctober 2026Rene Castillo

Europe's outcome-linked CAR-T terms, and where the treatment center sits

An outcome-linked rebate does not, by itself, establish the treatment center's payment terms.

Italy's published 2019 Kymriah arrangement

AIFA determination of 2019: the treating center pays the manufacturer in stages

The center's exposure. Part 1 is owed at infusion whatever the outcome, and the registry duty runs on every patient. The center's own funding from the region sits outside these terms.

The U.S. Medicaid CGT Access Model

Gene therapy for sickle cell disease, under CMS's model terms

The center's exposure. The rebate runs from the manufacturer to the state, not to the center. The center's payment depends on the state's terms and on meeting the registry condition; its timing is not set by the model.

Money that moves whatever the outcome
Money that depends on the outcome
The record that decides an outcome or a payment
The treatment center

Read the full analysis

Rene Castillo, Founder and Managing Principal, HealthPulse Advisors

Who does the work.

Rene Castillo founded HealthPulse Advisors and leads its work and its analysis.

Before founding HealthPulse, he managed a $2.5B managed-care portfolio at UCHealth and served as a healthcare administrator in the United States Air Force Medical Service Corps. He has also held research roles at Harvard Medical School and the Harvard T.H. Chan School of Public Health.

How an engagement begins.

1
One decision, one program
Bring the decision in front of you and the terms behind it: a contract, a proposed arrangement, or a product and the setting where it will be given.
2
Evidence before expansion
A defined first assessment with a real stop or go decision. Not an automatic path to a larger engagement.
3
A deliverable your team can use
Clients receive methods they can understand and deliverables they can use. Continuing work has to answer a real need.

The terms behind this are published as the firm's commitments.

Bring one program and one payer.

For a life-sciences team, bring the product and the setting where it will be given. A short conversation is enough to tell whether there is a question worth working on, including when the answer is no.

Discuss a decision