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.
Featured Content
How to Account for the Full Impact of Social Determinants of Health in Medicare Advantage Plans
Avalere experts recently presented “Risk Adjusting Medicare Advantage Plan Performance Measures for Social Determinants of Health: Are Dual Eligibility and Disability Status Enough?” at the Academy Health 2019 Annual Research Meeting.
Transitioning RA Drugs from Part B to Part D Would Increase Catastrophic Benefit Fills
New Avalere analysis finds that shifting Part B-covered rheumatoid arthritis (RA) drugs to Part D benefit would increase the share of prescriptions occurring in the catastrophic phase for impacted beneficiaries by more than 5 times.
Avalere Analysis Examines Drug Spending in Medicare Part D
As policymakers increasingly consider policy options to reform Medicare Part D and reduce program expenditures, an Avalere analysis examines spending across classes with various availability of brand and generic drugs.
Get the Most Out of In-Home Assessments to Retain Members and Improve Health Outcomes
As health plans evaluate more efficient ways to engage and retain members, they should focus on existing high-touch points to improve healthcare access and the overall experience. Augmenting these efforts can generate more evidence-based patient management thus improving overall health outcomes.
Avalere and Other Scientific Leaders Publish Paper on Advances in Value Frameworks
Paper details recent developments in leading value frameworks, including Avalere’s Focus on Patient Orientation in Value Assessment.
Is Tiered Provider Reimbursement on the Horizon for Medicare Part B?
As policymakers explore opportunities to reform Medicare Part B, a tiered average sales price (ASP) add-on payment may be under consideration to align system incentives and curb spending.
Proposed Rebate Rule May Impact Commercial Coverage in Some States
While the Department of Health & Human Services (HHS) did not intend for proposed changes to Anti-Kickback Statute (AKS) regulations to impact commercial market drug negotiations, some state laws may indirectly lead to commercial market implications.
Flu Vaccine Uptake Among Seniors Has Increased Steadily Since 2015
Avalere experts recently presented “A Comprehensive Analysis of Influenza Vaccine Uptake in Medicare” at the National Adult and Influenza Immunization Summit in Atlanta, GA.
Avalere Releases Recommendations to Drive More Patient Orientation in Value Assessment Methodology
Avalere published a white paper outlining global recommendations to increase the patient centricity of value assessment framework methodology and application.
Avalere’s Vaccines Experts Featured in Health Affairs Blog
On May 24, Avalere policy experts published a piece on the Health Affairs blog highlighting opportunities to leverage quality measurement tied to payment to drive adult immunization uptake and achieve national population health targets.
Testing Proves Usefulness of Avalere Shared Decision-Making Tool to Women with Advanced Breast Cancer
In 2018, Avalere partnered with CancerCare and Gabrielle Rocque, an oncologist at the University of Alabama Birmingham School of Medicine, to develop the Preparation for Shared Decision Making (PFSDM) tool.
Medicare Advantage Plans Outperform Fee-For-Service Medicare in Caring for Dual-Eligible Beneficiaries with Chronic Conditions
Avalere experts will present “Comparing Utilization, Cost and Quality in Dual Eligible Medicare Advantage and Fee-For-Service Medicare Beneficiaries” at the International Society for Pharmacoeconomics and Outcomes Research meeting on May 21.
CMS Finalizes Modified Medicare Advantage and Part D Changes
On May 16, the Centers for Medicare & Medicaid Services (CMS) released its final rule, Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses.
Avalere Commentary on Vague Vaccine Recommendations Featured in Health Affairs Blog
On May 7, Avalere policy experts published a piece in the Health Affairs blog about the Advisory Committee on Immunization Practices (ACIP) recommendations, and how they may be leading to provider practice confusion and potential access barriers for patients.
Care Pathways Offer an Opportunity to Improve Care Through Evidence-Based Practices
Care pathways can help providers make evidence-based decisions about where to focus care improvement efforts.
Administration Seeks Input on Federal STD Prevention and Treatment Initiative
On May 3, the Office of HIV/AIDS and Infectious Disease Policy, in partnership with other Department of Health and Human Services agencies, released a request for information (RFI) from stakeholders on strategies for the development of a Sexually Transmitted Diseases (STDs) Federal Action Plan, an initiative designed to address the domestic STD public health epidemic.
Avalere Partners with Leading Health Care Foundation, Provider Associations, and Advocacy Groups to Improve Conversations About Costs Between Patients and Clinicians
A supplement to Annals was just published that includes research on how to help physicians talk with their patients about costs of care, including a commentary co-authored with Avalere.
What Will Drive SNF Profitability Under the New Patient-Driven Payment Model?
Liz Moore recently sat down with Fred Bentley, managing director, to talk about the Patient-Driven Payment Model (PDPM) and how it may impact skilled nursing facility (SNF) profitability. Check out the interview below.
The Growing Presence of Pharmaceutical-Backed Corporate Venture Capital in Digital Health
As technology comes to the forefront in healthcare innovation, the venture capital arms of many pharmaceutical companies are solidifying their presence as key investors.
Enhancing Manufacturer Partnerships in an Evolving Specialty Landscape
Recent developments in the specialty pharmaceutical marketplace merit distinct attention from manufacturers.
