As the largest, single US healthcare payer, the government plays a dominant role in shaping the healthcare marketplace. Our experts track, interpret, and model federal policies that affect insurance coverage, access, and consumer choice so you can see around the bend.
Today, the Medicare Trustees delivered to Congress their annual report on the financial operations and status of the program.
New analysis from Avalere finds that states could see federal funding for their Medicaid programs decline by between 6% and 26% under the Better Care Reconciliation Act (BCRA) by 2026.
The 21st Century Cures Act presents medical product manufacturers, patient groups, and advocacy organizations with a unique opportunity to plan for upcoming policy changes that are aimed at accelerating the pace of development and approval of new therapies.
More than 40% of counties could see only one exchange plan in 2018, with risk that some counties may have no commercial options.
Today, the Trump Administration released its budget for fiscal year 2018 (FY 2018). The budget provides the President's recommendations for how the Congress should fund the government and marks the beginning of the FY 2018 budget season.
The elimination of cost-sharing reductions could lead to low-income individuals facing higher deductibles and maximum out-of-pockets.
New analysis from Avalere finds that Medicare Advantage (MA) patients use fewer post-acute care services after being discharged from the hospital compared to traditional Medicare fee-for-service (FFS) patients.
Funding earmarked for high risk pools in the American Health Care Act will cover five percent of the total number of enrollees with pre-existing chronic conditions in the individual market today.
Sean Creighton has joined the Avalere team as a vice president in the policy practice, and will be responsible for leading advisory services work tied to Medicare Advantage, risk adjustment, and related issues.
Today, the Centers for Medicare & Medicaid Services (CMS) released its final rule for market stabilization of the health insurance exchanges, following the departure of some health plans from the marketplace for the upcoming plan year.
Avalere experts examine proposed key reforms to the ACA and its potential impacts.
New research from Avalere finds that under the American Health Care Act (AHCA), large states as well as those states with fewer insurers offering plans in the individual and small group markets could receive the most money from the federal government to help stabilize their markets.
Low-income and older individuals would incur higher penalties for failing to purchase health insurance, compared to current individual mandate.
Avalere analyzed data from eight Medicare Advantage Organizations (MAOs) representing 1.1 million beneficiaries in more than 30 unique plans operating across the country to understand the impact of shifting the determination of plan risk scores from the traditional Risk Adjustment Processing System (RAPS) to the new Encounter Data System (EDS).
Today, the Trump administration released a proposed rule for market stabilization of the Affordable Care Act (ACA).
Avalere analyzed data from eight Medicare Advantage Organizations (MAOs) representing 1.1 million beneficiaries in more than 30 unique plans operating across the country to understand the impact of shifting the determination of plan risk scores from the Risk Adjustment Processing System (RAPS) to the new Encounter Data System (EDS).
Plans sold in exchange markets in 2017 feature higher premiums, growing consumer out-of-pocket costs, and more restricted access to providers and hospitals than in previous years, according to a new analysis from Avalere.
The final signing of the 21st Century Cures Act is the culmination of three years of efforts by lawmakers in the House and Senate to expedite developing and making available new treatment options. Listen to Cara Kelly break down the impacts in episode 1 of our series on 21st Cures.
Today, the House will vote on the updated version of the 21st Century Cures Act, H.R.34.
As 2017 exchange open enrollment begins, Avalere examined marketplace changes in plan choice and premiums at the county level.