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.
Emerging payment models will demand that hospitals establish tight and narrow networks of high performing post-acute care (PAC) providers.
A new literature review concludes that prescription drugs, when used appropriately, are often the most cost-effective component of the health care delivery system.
An Avalere analysis found that Medicare prescription drug plans (PDPs) had lower levels of coverage and fewer medicines on less expensive formulary tiers than commercial health insurance plans, potentially impacting patients' access to anticonvulsants.
Congress is likely to pass another short term doc-fix for CY2014.
Recent FDA decisions should act as a blueprint for generic and brand manufacturers of innovator products.
Avalere estimates that exchanges will enroll 8 million individuals and families in 2014, growing to 26 million in the next decade.
With DSH cuts looming, hospitals should enroll patients in coverage programs to minimize the burden of uncompensated care.
The growing pressure to manage patient care post-discharge in an efficient manner will drive significant growth in telemedicine over the next few years.
Nowhere are there more opportunities for savings than in post-acute care (PAC) settings.
To drive down costs, focusing exclusively on managing chronic illness misses the boat.
In this new era of payment reform, understanding patient populations and capabilities of providers outside of the hospital will be critical to success.
The number of drugs health plans are required to cover in the individual and small group markets will vary dramatically by state in 2014.
Avalere convened a meeting of healthcare leaders who outlined four critical areas to sustain innovation: infrastructure, evidence evaluation, evidence communication, and coverage and payment.
To decrease time to market and align data collection efforts, manufacturers must now engage with CMS and FDA more thoughtfully and earlier in the Category B IDE process.
Avalere research shows that enrollment in a voluntary long-term care insurance program would not be large enough to shift our financing system from Medicaid to private insurance.
The shift toward low-premium plans with preferred pharmacy networks is indicative of an increasingly competitive market, but don't expect that to mean decreased overall costs.
Reducing your hospital's MSPB score is an important first step in preparing to manage your patients' post-discharge costs.
New Medicaid payment methodologies inadequately reimburse specialty pharmacies by failing to account for drug costs and high-touch pharmacy services.
Hospitals aligned with top payers in the exchanges in their service areas will be well-positioned to benefit from increased volumes and revenues once exchanges start in January 2014.