Avalere Health
An Inovalon Company
Services

Market Access and Reimbursement

Optimize Access and Adoption

Today, an expanded universe of stakeholders are defining and evaluating the value of medical interventions beyond the requirements for FDA approval. Payers and providers develop utilization management strategies, including clinical pathways, appropriate use criteria, and bundled payments, to deliver value to the marketplace. Manufacturers also address evolving definitions of value by integrating customer needs and working with guideline and measure developers to ensure health outcome goals are met. Avalere looks at this complex world of commercialization through a single, yet multi-dimensional lens. We draw from policy expertise, private and public payer perspectives, patient and provider requirements, as well as a multitude of other stakeholders to create one integrated market strategy. Specifically, Avalere uses The Payer Edge®, our proprietary network of payer decision makers to inform your coverage and access action plan. From launching new technologies to navigating access challenges for existing products, we help you secure reimbursement and access.

What's Your Challenge?

  • Public and private payer landscape analysis
  • Distributor and specialty pharmacy strategies
  • Reimbursement tools: coding, pricing, contracting
  • Patient support services
  • Field team design and deployment strategy​

Complementary Products

Team

Meet a few of our experts ready to partner with you.

All Staff

Reginald Williams

Senior Vice President

Reginald
Williams

Reginald Williams, Senior Vice President, leads teams that deliver research, analytic, and strategic support to clients, with a focus on the needs of life sciences manufacturers and patient groups. He advises clients on medical technology policy, regulatory and market access strategies for new products, and the evolution of public and private payers' use of evidence for formulating coverage and reimbursement decisions, with a focus on the Medicare program.

Prior to joining Avalere, Reggie was a member of the health policy team at the National Academy of Social Insurance (NASI).He also served as the Howard R. Swearer Public Service intern in the Rhode Island Department of Health's Office of Minority Health.

Reggie has an AB in Biomedical Ethics from Brown University. He also serves on the board of directors of Mental Health America, a nonprofit dedicated to helping people live mentally healthier lives. He is a Patient-Centered Outcomes Research grant reviewer and a member of NASI and Health Technology Assessment International.

Rajiv Ahuja

Manager

Rajiv
Ahuja

Rajiv Ahuja, Manager, advises clients on market access, reimbursement and product commercialization for drugs, medical devices and laboratory tests. 

Prior to joining Avalere, Rajiv was an Associate in the Health Policy and Strategy practice group at Booz Allen Hamilton, where he advised military healthcare clients.  He also worked in the Veterans Engineering Resource Center (VERC) at the VA Pittsburgh Healthcare System where he performed process and quality improvement projects. Additionally, Rajiv practiced corporate law at DLA Piper LLP in Washington, DC.

 

Rajiv has an MS in Health Care Policy and Management from Carnegie Mellon University, a JD from the American University Washington College of Law, an MS in Information Sciences from the University of Pittsburgh and a BA from the George Washington University.

Kathy Hughes

Vice President

Kathy
Hughes

Kathy Hughes, Vice President, advises Avalere clients on value strategies, market access, and evidence planning.  Kathy partners with life sciences companies to scrutinize complex issues in market access, craft strategies and tactics to address them, and plan for and perform the analytics necessary for their success.

Prior to joining Avalere, Kathy was co-leader of the Market Access practice at Covance, and the Chief Operating Officer at Holy Cross Health Corp.  She has also served as Vice President for Corporate and Strategic Planning for Blue Shield of California, and Senior Manager with Ernst & Young’s Healthcare Management consulting practice.

Kathy has a BA from Brandeis University and a MBA from the University of Chicago.  She also has a Certificate of Completion from the Mid-Atlantic Health Leadership Institute at the Johns Hopkins Bloomberg School of Public Health and is a Senior Fellow at the Thomas Jefferson University School of Population Health.

Kunal Joshi

Senior Associate

Kunal
Joshi

Kunal Joshi, Senior Associate, supports clients on market access, product commercialization, and reimbursement policy. He utilizes his background in pediatric oncology regulatory programs, incentive programs, and medical sciences to maximize product access and improve healthcare delivery.

Prior to joining Avalere, Kunal was Director of Operations and Research at Kids v Cancer, performing necessary research on newly developed drugs, FDA policies, and the drug development process. In addition, he managed operations and developed program content. He also has experience as a Research Assistant at the Feinberg Cardiovascular Research Institute.

Kunal earned a BA from Northwestern University, and an MS in Biophysics and Physiology form Georgetown University.

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