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 former federal officials, Dan Troy, David Beier, and I share our perspectives on the call by former FDA officials representing both political parties to make the FDA an independent agency separate from its parent, HHS.
Avalere served as the document manager for the 2019 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline on the Primary Prevention of Cardiovascular Disease, released on March 17 at the ACC.19 Scientific Session. This guideline includes practical and concise evidence-based guidance for clinicians on the primary prevention of cardiovascular disease (CVD).
In February 2012, the Centers for Medicare & Medicaid Services (CMS) announced a final payment error calculation methodology for its contract-level Risk-Adjustment Data Validation (RADV) audits of Medicare Advantage (MA) plans.
As CMS continues to transition from the Risk Adjustment Processing System (RAPS) to the Encounter Data System (EDS) for Medicare Advantage (MA) risk score calculation, plans must evaluate operations and close gaps to minimize the impact of risk score differences using this claims data source.
Today continues a steady diet of healthcare cost hearings with committees on both sides of Capitol Hill digging into the issue.
In a new analysis, Avalere examines the implications of CMS’ potential new requirement that Part D plans place generics only on generic tiers.
Beginning in 2019, CMS will reimburse for 5 codes relating to virtual care delivery and remote monitoring
In a recent post on the Health Affairs Blog, we examine the potential uses and limitations of Medicare Advantage (MA) encounter data.
In early February, Avalere attended the annual Centers for Medicare & Medicaid Services (CMS) Quality Conference, an annual gathering that brings stakeholders together to address challenges in healthcare quality improvement and discuss ways to spread these solutions locally and nationally.
The swift proposed implementation timeline will require stakeholders to evaluate quickly operational requirements, behavioral responses, cross-program implications, and impact on contractual arrangements.
New research from Avalere finds that the provision of pneumococcal conjugate vaccines increased immediately after ACIP’s 2014 recommendation to add the vaccine to the routine immunization schedule for older adults.
Partnerships between traditional healthcare players and big technology companies seek to improve care delivery and patient outcomes in innovative ways.
ACO Experience Again Proves to Be an Indicator of Success
In February, Avalere is releasing a 4-part podcast series that focuses on how clinicians and other care team members can improve the quality and frequency of cost-of-care conversations with patients.
The transition from old-guard payer to wellness company is underway–and moving rapidly.
The costs of ensuring the safety and efficacy of imported drugs and preventing the entry of counterfeit products are among the many factors that must be weighed against any potential savings from a drug importation program.
While precision medicine is expected to revolutionize patient therapy, the increasing complexity of diagnostics is leading policymakers to revamp the way these tests are regulated and paid for.
Nearly 80,000 people died during the 2017–2018 influenza season. Only 37% of adults were vaccinated. Several novel emerging products could make vaccination more accessible and effective, potentially reshaping the market and lowering influenza disease burden.
New Avalere analysis finds that most seniors in Medicare would not see a reduction in their out-of-pocket costs as a result of the International Price Index Model.
Ambiguous recommendations for preventive services are causing confusion among plans and providers on the clinically recommended preventive services that should be covered without cost sharing. A recent USPSTF recommendation on HIV prevention offers an opportunity to urge a recommending body to provide further clarity in its recommendation. Comments are due December 26.