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.
COVID-19 continues to spread nationwide, and individuals with social risk factors and underlying chronic conditions are at highest risk for severe illness.
As control of the Medicaid drug benefit continues to shift from managed care organizations to states, manufacturers should understand unique benefit dynamics in each state, particularly as Medicaid enrollment is likely to increase amid the COVID-19 pandemic.
Prescription drugs are dispensed to patients through a complex supply chain that involves a broad array of entities, contract arrangements, and payments. The following diagram outlines how a typical prescription drug may flow through the drug supply chain.
A potential recession due to job losses and business closings as a result of COVID-19 will cause shifts in the payer mix and, ultimately, revenue dynamics for physician practices.
Citing alarming statistics that nearly 1 of every 2 older Americans is at risk of malnutrition and that disease-associated malnutrition in older adults is estimated to cost nearly $53 billion annually, a broad group of advocates has presented a updated roadmap for a continuing national effort to help millions of Americans who suffer from malnutrition or could be at risk as they age. The expected rising incidence of malnutrition amidst the current COVID-19 pandemic makes it even more critical to advance solutions across all points of care.
The COVID-19 pandemic has revealed several weaknesses in our country’s web of safety net programs. Although the virus may not discriminate, it may exacerbate existing health inequities driven by social determinants of health (SDOH).
Faced with a rapidly evolving healthcare environment, there are a number of important uncertainties that commercial insurers will need to consider when planning for the future
Avalere analysis of the distribution of provider relief funds indicates geographical concentration related to the number of reported COVID-19 cases.
A proposal to eliminate shoulder injuries from the list of vaccine-related conditions that warrant federal compensation through the National Vaccine Injury Compensation Program (VICP) highlights the administrative challenges posed by these claims and provides an opportunity to consider reforms to modernize the program.
State Medicaid programs face a series of near- and long-term challenges amid the COVID-19 pandemic due to enrollment growth and financial pressures. Stakeholders should evaluate key drivers shaping the state-by-state Medicaid outlook.
The impact of COVID-19 goes beyond the disease and produces additional strain on the healthcare system, including managing patients and meeting cost and quality drivers.
Mental Health Awareness Month and the COVID-19 crisis intersect—and highlight challenges in the US mental health care system
The Biologics Price Competition and Innovation Act (BPCIA) mandates that specific protein products that were approved as drugs under section 505 of the Federal Food, Drug, and Cosmetic Act (FD&C Act) be licensed as biologics under section 351 of the Public Health Services Act (PHS Act) as of March 23, 2020.
Recurring episodes of clostridioides difficile (c diff) create significant added healthcare burden and costs to society and lead to avoidable adverse outcomes in the Medicare population
Recent regulatory changes have eased restrictions for providers delivering care across state lines during the COVID-19 public health emergency. However, state and federal cooperation on extended licensure expansion would help address long-term provider access issues.
In a recent webinar, experts from Avalere and the National Patient Advocate Foundation discussed the value of shared decision-making (SDM) and preparing patients and families for navigating their care journeys.
The evolution of the US influenza vaccine market offers insights into the potential barriers and opportunities for successful rollouts of novel COVID-19 vaccines.
On February 27, Avalere experts discussed the latest policy, pricing, and reimbursement challenges for prescription drugs in Medicaid in the “What’s Next for Medicaid Drug Pricing?” webinar. They reviewed the ways prescription drugs are managed in Medicaid, what innovative medicines may mean for the program, and potential implications of CMS’ Healthy Adult Opportunity (HAO).
Major catastrophes, like natural disasters, global pandemics, and sudden economic downturns require rapid interventions to protect the American public from long-term health and financial damage. Because there is significant momentum and political will during and immediately following a catastrophe, promising innovations may be fast-tracked.
Although COVID-19 is introducing new challenges within the global pharmaceutical supply chain, the current situation also creates opportunities for stakeholders to evaluate drug security and implement risk-mitigation strategies around shortages and required stockpiles.