The Rubrum Philosophy: Using clinical expertise to solve market access challenges

On Aug. 5, 2023, I left my role as Chief Medical Officer and Director of the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS). The very next day, Aug. 6, I launched Rubrum Advising with my son, Matthew Fleisher JD, MPH. Our mission from day one: to help innovative health technologies reach patients by applying a clinical lens to solving market access challenges.

Two years in, that focus has never been more important. It is becoming increasingly recognized that the pathway for bringing new products to patient care begins rather than ends with FDA approval. To succeed, innovators must secure coverage from both federal and commercial payors, understand bundled vs. separate payments, and build the right clinical and economic evidence to prove value—whether to plans, policymakers, or health systems.

We know that, most often, a healthcare innovation’s success comes whenregulatory, clinical, business, and policy levers are aligned to support real-world use and long-term adoption. At Rubrum, we use a systems-level approach to help ensure clients’ new technologies or therapies reach the right patients, in the right settings, at the right time—and deliver measurable outcomes that matter. This creates pull from the market in the form of provider demand, patient relevance, and payer alignment that fuels the entire commercialization arc.

I’m proud that in the last two years, Rubrum Advising has deepened our bench and broadened our perspective, combining clinical credibility with regulatory insight and policy fluency. Together, our incredible team of current and former clinicians, health system leaders, policymakers, and private-sector experts offers clients a birds-eye view of the entire healthcare ecosystem, which makes us uniquely positioned to help clients turn great ideas into real impact.

Since 2023, we’ve expanded our work to include policy and regulatory strategy; brought together some of the nation’s top hospital quality experts to help health systems manage operational, financial, and accreditation risks; and launched a government affairs team that helps shape conversations with the right decision-makers. And this summer, we published our first newsletter for clients. The Rubrum Report is a monthly digest that offers relevant updates across health policy, regulation, and legislation.

Today, Rubrum Advising’s North Star remains clear: helping patients access meaningful, high-impact care by aligning innovation with the clinical knowledge, regulatory frameworks, and policy trends that deliver it. I’m grateful to everyone who has joined us on this journey, and excited about what’s ahead.