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.
Telehealth has the potential to expand access to healthcare by allowing people to interact with providers remotely, but disparities affect access to the technology that makes telehealth possible.
Most states will begin new legislative sessions in 2023. Drug pricing, patient affordability, and coverage protection will be priorities in many states.
The EOM prediction model and benchmarking methodology are more precise than that of the OCM, which will heighten the ability of participants to directly manage costs, including oncolytic spend.
Avalere identified 19 states that must change their Medicaid vaccine policies to comply with the IRA’s requirement that states cover all recommended vaccines without cost sharing.
Assessing barriers that impact patient access to obesity care and educating stakeholders on how to mitigate them can advance solutions toward improving care.
Digital health tools are an increasingly important component of complete patient support solutions that can optimize patient care, yet they are currently underutilized.
On November 4, Avalere presented a poster on disparities in wait times for kidney transplants at the American Society of Nephrology (ASN) Kidney Week 2022 conference.
The COVID-19 pandemic has catalyzed the growth of hybrid care delivery models, highlighting the need for clinical guidance and stakeholder agility.
IRA would lead to a minimum 47% add-on payment reduction on average for Medicare providers who furnish the Part B drugs initially targeted for negotiation.
New report on the evolving cell and gene landscape features Avalere Health experts Kylie Stengel and Mark Von Eisenburg.
Analysis shows adding prescription drug copay caps to Part D benefit redesign could reduce OOP costs by 45% per enrollee.
Since passage of the Affordable Care Act (ACA), 39 states and DC have expanded Medicaid. Some of the remaining states may reconsider expansion given new federal funding incentives.
Fifteen states have enacted legislation requiring payers and PBMs to count copay assistance toward patient cost-sharing limits.
The MPFS final rule implements the discarded drug refund requirement for certain single-use physician-administered drugs, presenting risks to manufacturers of these products.
Traditional health technology assessments fall short in accounting for how therapy addresses the total burden of illness experienced by affected individuals.
Implementation of the OOP smoothing program will require additional clarity from the Centers for Medicare & Medicaid Services (CMS) on elements that will affect beneficiary experience, access, and overall sustainability of the smoothing program.
A new Avalere analysis shows the Accelerated Approval pathway provides access to underserved Medicare beneficiaries across a range of conditions with unmet needs.
The end of the public health emergency (PHE) raises policy questions around implications for reimbursement, patient access, and operationalization of telehealth service delivery.
President Biden’s executive order directs HHS to identify CMMI model options that could lower drug costs and promote access for Medicare and Medicaid enrollees.
The ESRD QIP is the first pay-for-performance program that penalizes dialysis facilities for not meeting performance thresholds.