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.
As policymakers explore opportunities to reform Medicare Part B, a tiered average sales price (ASP) add-on payment may be under consideration to align system incentives and curb spending.
While the Department of Health & Human Services (HHS) did not intend for proposed changes to Anti-Kickback Statute (AKS) regulations to impact commercial market drug negotiations, some state laws may indirectly lead to commercial market implications.
Avalere experts recently presented “A Comprehensive Analysis of Influenza Vaccine Uptake in Medicare” at the National Adult and Influenza Immunization Summit in Atlanta, GA.
Avalere published a white paper outlining global recommendations to increase the patient centricity of value assessment framework methodology and application.
On May 24, Avalere policy experts published a piece on the Health Affairs blog highlighting opportunities to leverage quality measurement tied to payment to drive adult immunization uptake and achieve national population health targets.
In 2018, Avalere partnered with CancerCare and Gabrielle Rocque, an oncologist at the University of Alabama Birmingham School of Medicine, to develop the Preparation for Shared Decision Making (PFSDM) tool.
Avalere experts will present “Comparing Utilization, Cost and Quality in Dual Eligible Medicare Advantage and Fee-For-Service Medicare Beneficiaries” at the International Society for Pharmacoeconomics and Outcomes Research meeting on May 21.
On May 16, the Centers for Medicare & Medicaid Services (CMS) released its final rule, Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses.
On May 7, Avalere policy experts published a piece in the Health Affairs blog about the Advisory Committee on Immunization Practices (ACIP) recommendations, and how they may be leading to provider practice confusion and potential access barriers for patients.
Care pathways can help providers make evidence-based decisions about where to focus care improvement efforts.
On May 3, the Office of HIV/AIDS and Infectious Disease Policy, in partnership with other Department of Health and Human Services agencies, released a request for information (RFI) from stakeholders on strategies for the development of a Sexually Transmitted Diseases (STDs) Federal Action Plan, an initiative designed to address the domestic STD public health epidemic.
A supplement to Annals was just published that includes research on how to help physicians talk with their patients about costs of care, including a commentary co-authored with Avalere.
As technology comes to the forefront in healthcare innovation, the venture capital arms of many pharmaceutical companies are solidifying their presence as key investors.
Recent developments in the specialty pharmaceutical marketplace merit distinct attention from manufacturers.
On April 5, CMS issued guidance announcing a voluntary, 2-year demonstration that would modify the Part D risk corridors if the proposed rule to revise the Anti-Kickback Statute safe harbors is effective for 2020.
An April 9 hearing before the Senate Finance Committee entitled “Drug Pricing in America: A Prescription for Change” included discussion related to cost-sharing for preventive services in the Medicare Part D.
CMS announced the new CMS Primary Cares Initiative, comprising 5 new payment models under 2 programs, which will test the impact of providing considerable financial incentives and flexibility to primary care practices and organizations in exchange for significant provider risk.
The Centers for Medicare & Medicaid Services (CMS) is currently reviewing a new payment rule, which could impact coverage of innovative procedures like transcatheter aortic valve replacement for the treatment of severe aortic stenosis.
The Centers for Medicare & Medicaid Services released the final Notice of Benefit and Payment Parameters (NBPP) for the 2020 plan year. This annual rule, released today, updates guidance and regulations related to exchanges as well as the broader individual, small group, and large group insurance markets.