News
Final Rule Lowers Barriers to Forming and Joining Association Health Plans
On June 19, the Department of Labor (DOL) released its final rule on Association Health Plans (AHP).
Double-Digit Premium Increases Expected in the Exchange Market in 2019
2019 rate filings suggest increased competition and plan choice
Opioid Supply Levels Decline in Most States
Maine had the greatest decline at 25% compared with the national average of 11%.
More than 1 in 5 Medicare Cancer Patients Receive Care from Oncology Care Model Doctors
More than 25% of patients with breast and lung cancers have been treated by a participating Oncology Care Model doctor. Participation trends could accelerate the transformation of treatment for some cancers, according to Avalere experts.
Seniors Pay More for Medicare Part D Generics Despite Stable Prices
Avalere analysis finds that price of generic drugs has remained flat but the cost to seniors is increasing.
Avalere Analysis Highlights Complexities of Transitioning Medicare Part B Drugs into Part D
Moving certain Part B drugs to Part D, a proposal being evaluated by the Trump administration, would have disparate financial impacts on patients.
The Complexities of Transitioning Medicare Part B Drugs into Part D
Moving certain Part B drugs to Part D, a proposal being evaluated by the Trump administration, would have disparate financial impacts on patients.
More Medicare Part D Enrollees Are Reaching Catastrophic Coverage
Patient out-of-pocket costs continue to grow despite policies to increase affordability for beneficiaries.
Registries Continue to Give More Opportunities for Clinicians to Meet Reporting Requirements
The number of CMS-approved Qualified Clinical Data Registries grew by 40% in 2018, allowing specialties to have more opportunities to report on meaningful quality measures.
Medicare ACOs Have Increased Federal Spending Contrary to Projections That They Would Produce Net Savings
Incentive payments in upside-only Medicare ACOs have increased federal costs, but data suggest that ACO experience and adoption of two-sided risk could constrain future Medicare costs.
Medicare Patients Are Using Fewer Skilled Nursing Services
New research from Avalere finds Medicare beneficiaries are spending fewer days in skilled nursing facilities (SNFs) since 2009 on a per capita basis.
Association Health Plans Projected to Enroll 3.2 Million Individuals
New analysis from Avalere finds that the proposed rule on association health plans (AHPs) is projected to lead to 3.2M enrollees shifting out of the Affordable Care Act's (ACA) individual and small group markets into AHPs by 2022.
Midwest and Mid-Atlantic States Face Provider Shortage to Address Opioid Epidemic
New research from Avalere Health finds 11 states and DC lack an adequate number of providers certified to prescribe buprenorphine, a medicine used to prevent relapse in people with opioid dependence.
Medicare Part B Payment Increases Will Offset 340B Drug Reimbursement Cuts for 85% of Hospitals
Rural hospitals will see an average 2.7% net increase of Part B payments.
Avalere Analysis Shows that Health Needs and Cost of Medicaid Expansion Populations Grow over Time
Beneficiaries show signs of pent-up demand with acute healthcare needs early in their enrollment, but over time costs increase substantially and shift toward chronic care.
Medicare Financial Incentives Encourage Providers to Take on Greater Financial Risk
While clinicians have been hesitant to assume risk, bonus payments would result in 9 out of 10 ACOs and their participants achieving a net positive financial impact.
Avalere Expands Actuarial and Data Analytics Expertise with Hire of Kenny Kan
Kenny Kan has joined the Avalere team leading the firm's actuarial analytics. Prior to joining Avalere, Kan served as the Chief Actuary at Humana and CareFirst.
Avalere Develops Report on Opioid Analgesic Trends
Resource presents trends in opioid painkiller prescriptions and deaths due to misuse and abuse.
California, North Carolina, and New York Will See the Largest Provider Payment Cuts and Beneficiary Savings Due to 340B Program Changes
Analysis also finds that 62% of impacted facilities will experience less than a 5% reduction in Medicare Part B revenue due to the drug cuts, but 6% of applicable hospitals will experience cuts greater than 10%.
Funding Reinsurance and Cost-Sharing Reductions Would Lower Individual Market Premiums and Increase Enrollment
New analysis by Avalere examines the impact of two market stabilization proposals-funding the cost-sharing reductions (CSRs) and implementing a federal reinsurance program-on individual market premiums and enrollment.