News
States Choosing Healthy Adult Opportunity Program Will Need to Generate Savings to Stay Below Capped Funding Levels
New analysis from Avalere finds that states currently covering non-mandatory adult populations who choose to participate in the Healthy Adult Opportunity (HAO) initiative may need to generate up to 8% in Medicaid savings to keep spending below new capped funding levels.
First Quality Measures Aim to Reduce Diabetes Complications
Avalere Health and the Endocrine Society launch hypoglycemia clinical tools.
2020 Exchange Plan Networks Are the Most Restrictive Since 2014
Restrictive network plans comprise over 75% of the exchange market.
2020 Election: Democratic Healthcare Proposals May Impact 43 to 329 Million Americans
New analysis from Avalere finds that Democratic proposals to expand public programs, such as a public option or single payer, will impact substantially different populations depending on how they are designed.
Free Exchange Plan Options Are Available to Many Low-Income Consumers for 2020
New analysis from Avalere finds that over 96% of counties with exchanges operated by HealthCare.gov have free plan options for low-income consumers.
State-Run Reinsurance Programs Reduce ACA Premiums by 16.9% on Average
Continuing analysis from Avalere finds that state reinsurance programs reduce individual market premiums by 16.9% on average in their first year, relative to estimated premiums without reinsurance.
Healthcare 2020: Facts and Figures in Advance of the Next Democratic Debate
With the 2020 presidential election nearly 1 year away, healthcare reform remains one of the top issues for voters heading into the election year.
Physician-Led Accountable Care Organizations Outperform Hospital-Led Counterparts
Medicare ACOs continue to realize experience-level results.
Tom Kornfield Returns to Avalere Health, Expanding Firm’s Depth in Medicare Policy
Healthcare industry veteran brings decades of Medicare Advantage, Part D, risk adjustment, and business expertise to payer, life sciences, and provider clients.
More than Half of Health Plans Use Outcomes-Based Contracts
Cost savings and improved clinical outcomes cited as top advantages for payers according to survey conducted by Avalere Health.
Fentanyl Supply Levels Declined in All States from 2014 to 2017 as Deaths from Overdoses Increased
New analysis from Avalere finds that the quantity of retail fentanyl sold across the US dropped by an average of 28%, between 2014 and 2017.
Avalere and the Robert Wood Johnson Foundation Launch Initiative to Transform Health Systems
Avalere will serve as the RWJF Health Systems Transformation Research Coordinating Center to meet patients’ interrelated clinical and social needs.
Capped Funding Policies Could Reduce Funding for Children Covered by Medicaid
New research from Avalere finds that capped funding policies could reduce federal funding to states, specifically for children, by $89B to $163B nationally for FY 2020–2029.
Avalere Adds New Experts in Payer, Pharmacy Benefit Management, Provider and Specialty Markets
Dr. Roy Beveridge and Mike Schneider Join the Firm
Avalere Adds New Expert in Vaccines
Dr. Angela Shen Joins the Firm
The Administration Provides Employers and Employees with Enhanced Flexibility in Connection with Health Reimbursement Arrangements
Final rule by the Treasury Department, Department of Labor, and the Department of Health and Human Services reverses previous Treasury Department guidance blocking tax-advantaged HRAs that were not integrated with a comprehensive employer-sponsored plan.
Cancer Treatment Costs Are Higher Among Oncology Care Model Participants than Benchmarks Predict
A new Avalere analysis finds that oncology practices participating in the Oncology Care Model (OCM) treated patients with 2–3% higher Medicare costs per episode, on average, than OCM prediction model estimates during the first two performance periods.
Avalere Deepens Expertise in Medicare and Clinical Decision-Making with 2 New Hires
Matt Kazan and Amy Schroeder bring unique understandings of how policy and clinical data drive healthcare markets.
More than Half of All OCM Providers Could Owe CMS Money if Required to Join in 2-Sided Risk Model
Pressure to lower costs will increase for OCM providers as CMS pushes to 2-sided risk.
BPCI Advanced Continues to See Robust Participation, Even as Providers Begin to Take on Risk
Providers in the Bundled Payments for Care Improvement Advanced initiative began to assume financial risk on March 1, 2019.