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.
In this week's edition of McKnight's Long-Term Care News & Assisted Living, Avalere's Jennifer Rak wrote a guest blog piece on the effects of the recently released Final Medicare Advantage (MA) Rates.
On April 17, the HHS Office of Inspector General (OIG) released a report evaluating the impact on total Medicare expenditures of the payment differential between hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs).
On April 15, CMS released a revised version of the ESRD Seamless Care Organizations (ESCOs) Request for Application (RFA).
In this week's edition of McKnight's Long-Term Care News & Assisted Living, Avalere's Brian Fuller wrote a guest post discussing the merits behind PAC provider bundling.
On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released updated estimates on health insurance coverage provided through the ACA.
On April 11, UHC announced that they will no longer implement their policy to ban the use of manufacturer-provided retail copay coupons.
On April 9, the World Health Organization (WHO) issued its first guidance for the treatment of hepatitis C infection (HCV).
On April 9, CMS released cost and utilization data on services provided to Medicare fee-for-service (FFS) beneficiaries by physicians and other healthcare professionals in calendar year (CY) 2012.
On April 9, pharmacy benefit manager (PBM) Express Scripts released a report highlighting prescription drug utilization by enrollees in new exchange plans.
On April 7, CMS finalized their Calendar Year (CY) 2015 capitation rates, methodological changes to rates and risk models, and other payment and program policies for Medicare Advantage (MA) and Part D plans.
On March 27, the American College of Cardiology (ACC)/ American Heart Association (AHA) announced that they will begin to include cost and value information in their guidelines recommendations, while simultaneously publishing a methodology statement on how guideline writing committees should incorporate this information.
An Avalere Health study commissioned by The Pew Charitable Trusts examined how payers cover medical devices that come to market and what role the extent of evidence generated to seek FDA approval impacts downstream coverage and payment for these devices.
On April 3, HHS released a draft report with proposed strategies and recommendations for health information technology (HIT) regulation.
700K to 1.3M Additional Medicaid Enrollees through March, If Current Trends Continue.
In 2014, most states are choosing to cover new Medicaid eligibles with the same benefit package that current eligibles receive.
On March 31, the Senate passed the "Protecting Access to Medicare Act of 2014," which was passed in the House last week, to provide a temporary fix to the Sustainable Growth Rate (SGR) formula.
On March 27, the United States Prevention Services Task Force (USPSTF) released for public comment a draft research plan, "Primary Care Screening for Depression in Adults," taking the first step in the process to update its recommendation released in 2009.
On March 26 and 27, FDA's Advisory Panel reviewed two DNA-based colorectal cancer (CRC) screening tests, Epigenomics-Epi proColon® Septin 9 test and Exact Sciences-Cologuard®.
On March 25, OIG released an updated report on Medicare payments for End Stage Renal Disease (ESRD) drugs.
As 2014 open enrollment comes to a close, core issues (listed below) associated with exchange implementation remain unsettled.