News
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.
Teigland Invited to Serve on PQA Executive Research Advisory Council
Christie Teigland, PhD, has been invited to serve on the Pharmacy Quality Alliance (PQA) Executive Research Advisory Council (ERAC).
State-Run Reinsurance Programs Reduce ACA Premiums by 19.9% on Average
New analysis from Avalere finds that states with their own reinsurance programs reduce individual market premiums by 19.9% on average in their first year.
HHS Proposed Changes Could Reduce ACA Coverage and Increase Premiums
New analysis from Avalere finds that exchange plan sign-ups could decline by 1.1 million, while premiums could increase by 6.3%, by 2025 should HHS finalize recently proposed changes to auto-reenrollment in the exchange and the calculation of tax credit subsidies.
Avalere Welcomes Jason Altmire as Senior Advisor
Former U.S. Congressman Jason Altmire has joined Avalere Health as a senior advisor, offering his deep understanding of the policy-making process to inform business strategy.
HHS Proposes to Remove Safe Harbor for Drug Manufacturer Rebates
Yesterday, the Department of Health and Human Services Office of Inspector General released a proposed rule redefining the current safe harbor for pharmaceutical manufacturer discounts and rebates to entities like health plans and pharmacy benefit managers (PBMs).
CMS Highlights Potential Changes that Could Restrict Access to and Increase the Costs of Certain Brand Drugs to Obamacare Enrollees
The Centers for Medicare & Medicaid Services released the proposed Notice of Benefit and Payment Parameters (NBPP) for the 2020 plan year. The rule could limit exchange plan enrollees' access to certain brand name drugs and increase the out-of-pocket costs within plans.
Free Exchange Plan Options Are Available in Most Counties for 2019
New analysis from Avalere finds that over 95% of counties with exchanges operated by HealthCare.gov have free plan options for low-income consumers.