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.
Our analysis finds there will be winners and losers at the plan level under the new models.
With the 2018 mid-term elections weeks away, polls show healthcare is a top issue on the minds of voters.
Join Avalere experts for our analysis of CMS’ 2019 Star Ratings and a look at what’s to come for 2020 on our webinar on November 1, 2018.
New research from Avalere finds that Medicare patients with rheumatoid arthritis (RA) may face higher out-of-pocket costs under a proposal to move Medicare Part B drugs into Part D, absent additional policy change to lower cost sharing in the Part D program.
Average premiums projected to grow 3.1% heading into next year.
In its proposed changes to the Medicare Physician Fee Schedule (MPFS) for Calendar Year 2019 (CY2019), the Centers for Medicare & Medicaid Services (CMS) proposes a potentially sweeping change to the way it values physician office and outpatient visits, also known as Evaluation & Management (E/M) codes.
New research from Avalere finds that Medicare Advantage (MA) beneficiaries with hypertension, hyperlipidemia, and diabetes experienced significantly fewer inpatient stays and emergency room visits relative to those in traditional fee-for-service (FFS) Medicare.
On June 19, the Department of Labor (DOL) released its final rule on Association Health Plans (AHP).
2019 rate filings suggest increased competition and plan choice
In its 2018 Report, the Medicare Trustees issued a Medicare funding warning, citing concerns over the program's near-term financial health and spending impact on the federal budget.
Avalere analysis finds that price of generic drugs has remained flat but the cost to seniors is increasing.
Patient out-of-pocket costs continue to grow despite policies to increase affordability for beneficiaries.
Avalere's founder and president, Dan Mendelson, recently sat down with Senior Housing News editors to discuss opportunities for senior living providers to leverage data to facilitate synergistic partnerships with payers.
The House and Senate are advancing legislative packages aimed at mitigating the crisis.
Avalere examines the effect of foundation-sponsored financial assistance on out-of-pocket costs and federal spending.
Coordinated information sharing can facilitate the delivery of integrated care to patients using both physical and behavioral health services.
In response to the concern that overprescribing is a driver of the opioid crisis, payers are limiting opioid fills as one solution.
The Centers for Medicare & Medicaid Services released the final Notice of Benefit and Payment Parameters (NBPP) for the 2019 plan year.
New research from Avalere finds Medicare beneficiaries are spending fewer days in skilled nursing facilities (SNFs) since 2009 on a per capita basis.
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.