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.
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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.
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.
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.
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.