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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.

Few Medicare Beneficiaries Receive Comprehensive Medication Review Services

A new analysis from Avalere Health finds that less than half of all Medicare prescription drug (Part D) enrollees eligible for medication therapy management (MTM) programs receive these services. Under Medicare rules, the Centers for Medicare & Medicaid Services (CMS) requires all Part D plans to provide MTM services to beneficiaries who meet certain criteria and have high drug utilization.

Avalere Health Insurance Exchange Map

On July 22, the U.S. Court of Appeals for the D.C. Circuit ruled contrary to lower courts and struck down the IRS's regulations allowing consumers to receive subsidies for insurance purchased on federally-facilitated exchanges.

Paying for the High Cost of Care

This July, Avalere's Tanisha Carino and Scott Gottlieb published a paper on, discussing the ways in which medical research for major diseases continues to advance, while simultaneously making cures more expensive upfront.

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