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.
A Medicare proposed rule change limiting the number of prescription drug plans (PDPs) that insurers may offer in the Part D market could require 39 percent of all enhanced plans to be eliminated in 2016.
On Feb. 3, the Agency for Healthcare Research and Quality (AHRQ) released a white paper that provides payer perspectives on how to improve the usability of reports produced by AHRQ's Effective Health Care (EHC) program.
On Feb. 4, the Office of the Inspector General (OIG) released a report describing select covered entities' contract pharmacy arrangements and their oversight to prevent diversion of 340B purchased drugs to ineligible patients, and to prevent duplicate discounts through Medicaid.
Avalere analysis from the February "State Reform Insights" shows that in addition to the 26 states and D.C. committed to expending Medicaid in 2014, Utah, Tennessee and Indiana could follow suit.
On Feb. 3, the Measures Application Partnership (MAP) released its final pre-rulemaking report, providing recommendations on the adoption of new measures in more than 20 federal public reporting and payment programs, including clinician programs (e.g., Physician Quality Reporting System, Physician Compare) and facility programs (e.g., Inpatient Quality Reporting System (IQR), Hospital Acquired Conditions Payment Reduction Programs).
On Feb. 4, CMS published a draft letter to issuers seeking to offer qualified health plans (QHPs) and standalone dental plans (SADPs) in the FFM or federally-facilitated small business health options program (FF-SHOP).
In this year's Outlook, Avalere experts analyze which key events will impact your industry most, and when to start to prepare.
Previously, I have written about the role that increased data transparency can play in improving trust in biopharmaceutical and medical products industry-funded research and the credibility of industry-sponsored study results.
Avalere estimates that from October through December 2013, between 1.1M and 1.8M people have newly enrolled in Medicaid as a result of the Affordable Care Act (ACA).
CMS released financial results on Jan. 30 indicating that nearly half of the Medicare ACOs (54 of 114) had lower expenditures than projected in their first year of participation.
On Jan. 27, the IRS published a proposed rule to clarify and modify the requirement that individuals have minimum essential coverage (MEC) starting in 2014.
On Jan. 28, the United States Prevention Services Task Force (USPSTF) released the draft recommendation for public comment, "Screening for Abdominal Aortic Aneurysm."
Avalere's Anne Tumlinson, Senior VP, Provider Client Solutions, will be participating on a panel at the Senior Living 100 conference in Laguna Nigel, CA on Feb. 24 at 11am, titled: "Using Historical and Predictive Analysis to Drive Organizational Strategy."
PCORI will fund more head-to-head trials that compare two or more efficacious treatment alternatives for the therapeutic area being examined.
The Government Accountability Office (GAO) released a report comparing ACA-based federal upper limit (FUL) amounts to National Average Drug Acquisition Cost (NADAC) amounts for 1,035 Medicaid-reimbursed outpatient drugs.
The American College of Radiology (ACR) is leading a coalition to encourage CMS to open a national coverage determination (NCD) on lung cancer screening.
NEWS RELEASE: PuttingPatientsFirst.net uses Avalere Health analytics to educate consumers about marketplace choices.
Despite the challenging exchange rollout, more than 1.8 million individuals signed up for exchange coverage in December alone, bringing total enrollment to 2.2 million during the first three months of open enrollment.
On Jan. 14, FDA issued draft guidance for industry called "Fulfilling Regulatory Requirements for Postmarketing Submissions of Interactive Promotional Media for Prescription Human and Animal Drugs and Biologics."
On Jan. 14, HHS announced that it will begin responding to Freedom of Information Act requests for physician-payment information.