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.
Analysis: Access to Anticonvulsant Therapy
An Avalere analysis found that Medicare prescription drug plans (PDPs) had lower levels of coverage and fewer medicines on less expensive formulary tiers than commercial health insurance plans, potentially impacting patients' access to anticonvulsants.
SGR Patch in 2014 Likely
Congress is likely to pass another short term doc-fix for CY2014.
FDA Sets Precedents on Abuse-Deterrent Product Regulation
Recent FDA decisions should act as a blueprint for generic and brand manufacturers of innovator products.
Three Critical Factors for Exchange Success
Avalere estimates that exchanges will enroll 8 million individuals and families in 2014, growing to 26 million in the next decade.
What You Need to Know About DSH Cuts
With DSH cuts looming, hospitals should enroll patients in coverage programs to minimize the burden of uncompensated care.
Providers Look to Telemedicine to Manage Risk
The growing pressure to manage patient care post-discharge in an efficient manner will drive significant growth in telemedicine over the next few years.
Three Strategies to Reduce PAC Spending
Nowhere are there more opportunities for savings than in post-acute care (PAC) settings.
Three Strategies to Manage High-Cost Populations
To drive down costs, focusing exclusively on managing chronic illness misses the boat.
Reinventing the American Hospital
In this new era of payment reform, understanding patient populations and capabilities of providers outside of the hospital will be critical to success.
Rx Coverage in Exchanges to Vary by State
The number of drugs health plans are required to cover in the individual and small group markets will vary dramatically by state in 2014.
Solving the Long-Term Care Cost Problem
Avalere research shows that enrollment in a voluntary long-term care insurance program would not be large enough to shift our financing system from Medicaid to private insurance.
Four Areas Key to Sustaining Innovation
Avalere convened a meeting of healthcare leaders who outlined four critical areas to sustain innovation: infrastructure, evidence evaluation, evidence communication, and coverage and payment.
2013 Part D Enrollees Attracted by Preferred Pharmacy Networks
The shift toward low-premium plans with preferred pharmacy networks is indicative of an increasingly competitive market, but don't expect that to mean decreased overall costs.
Act Now to Avoid 2015 VBP Program Cuts
Reducing your hospital's MSPB score is an important first step in preparing to manage your patients' post-discharge costs.
Tracking Gaps in State Specialty Pharmacy Reimbursement
New Medicaid payment methodologies inadequately reimburse specialty pharmacies by failing to account for drug costs and high-touch pharmacy services.
Exchange Strategy Critical to Recouping Reimbursement Losses
Hospitals aligned with top payers in the exchanges in their service areas will be well-positioned to benefit from increased volumes and revenues once exchanges start in January 2014.