Insights & Analysis
There’s one constant in healthcare: change. Count on us to break down the trends so you can stay up to date. Follow our take on each piece of this deep, intertwined, and often perplexing industry to find opportunities and practical approaches to move healthcare forward.
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Mental Health Parity Rule: Industry Reactions and Implications
Stakeholders are contending with a new rule implementing stricter requirements on mental health care parity to ensure patient coverage and enhance equity.
Stakeholders Can Engage USP During DC 2025 Comment Period
The USP DC 2025 Draft is open for public comment until October 31, allowing stakeholders to engage with the USP even in years without an update to the MMG.
50-State Comparison of Medicaid Adult Vaccine Provider Reimbursement in 2024
A new Avalere analysis reaffirms 2021 findings that first identified variability in Medicaid physician office and pharmacy vaccine reimbursement policies.
eBook: Navigating the Immunization Ecosystem
In this eBook, Avalere experts discuss the evolving vaccines ecosystem and analyze key policy issues affecting vaccines manufacturers.
Number of Part D Plan Choices Declines for 2025
The number of PDP and MA-PD options are declining by 26% and 7%, respectively, in 2025.
Avalere White Paper: The State of Quality in Rare Disease
Avalere assessed quality measurement, quality improvement, and value-based initiatives in rare disease and the opportunity for a cohesive quality strategy.
VP Debate Highlights Healthcare Policy Differences
During the debate, VP candidates outlined their views on healthcare topics such as the ACA, drug pricing, manufacturing, reproductive rights, and mental health.
Navigating the Medicare Prescription Payment Plan: What It Means for Part D Plan Sponsors
The MPPP introduces new considerations for Part D plans’ financial risk, operations, and enrollee engagement.
OIG Requests Enhanced Oversight of Remote Patient Monitoring
The OIG found oversight gaps in Medicare's RPM program, especially in billing accuracy and integrity, highlighting need for safeguards and provider education.
Accelerating Access through Payer Marketing
Payer marketing requires a strategic approach that combines data and storytelling to communicate product value and differentiation and ensure patient access.
Navigating the Medicare Prescription Payment Plan: What It Means for Manufacturers
The MPPP will help improve Part D patient affordability, prompting manufacturers to reassess existing patient assistance programs and educational efforts.
eBook: Women’s Health Landscape
In an eBook, Avalere experts analyze the spectrum of women’s health needs and research the coverage, care, and outcomes shaping women’s health services.
SNF 3-Day Waiver Use at the End of the COVID-19 Public Health Emergency
Use of the three-day waiver was stable over the course of the pandemic, though shifts in admission sources were observed.
Navigating the Medicare Prescription Payment Plan: What It Means for Patients and Patient Groups
The MPPP is a new payment option for Part D beneficiaries in 2025; patient groups will play a key role in supporting education and outreach on the program.
Medicare Cost and Utilization Across Physician Affiliation Models
An Avalere analysis assessing differences in Medicare expenditures and utilization across 4 models provides a new perspective on the evolving physician affiliation model landscape.
IRA Inflation Rebate Impact on Part B Beneficiary OOP Costs
Avalere finds that between 0.1% and 0.2% of Medicare FFS beneficiaries would experience lower OOP costs for the Part B drugs subject to Q3 2024 inflation rebates.
IRA Negotiations May Affect Millions of Medicare Beneficiaries
Maximum fair prices for the first 10 selected drugs may shift therapeutic dynamics and have direct and indirect impact to millions of beneficiaries.
Commercial Spillover Impact of Part B Negotiations on Physicians
Physicians could lose at least $25 billion in add-on payments for 10 Part B drugs expected to be negotiated by CMS, with oncology products accounting for at least $12 billion.
Navigating the Medicare Prescription Payment Plan: What It Means for Stakeholders
The Medicare Prescription Payment Plan will change how Medicare beneficiaries manage their Part D out-of-pocket costs, with implications across stakeholders.
Key Considerations for MFP Effectuation and the 340B Rebate Model
Stakeholders consider implementation of a 340B rebate model to address duplicate discount risk.