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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.
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.
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.
Rural hospitals will see an average 2.7% net increase of Part B payments.
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.
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.
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.
Resource presents trends in opioid painkiller prescriptions and deaths due to misuse and abuse.
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%.
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.
Deductibles remain high, nearing $4,000 on average for silver plans.
Brow was most recently regional SVP of The US Oncology Network for McKesson.
If federal government permits states to expand Medicaid to only 100% of poverty, nearly 4M people could shift from Medicaid to exchanges, and 7M could be newly eligible for coverage.
New analysis from Avalere finds that nearly 98% of counties with exchanges operated by HealthCare.gov will have free bronze plan options for low-income consumers aged 50 earning 150% of poverty or less ($18,090 for an individual or $36,900 for a family of four).
New analysis from Avalere finds that the 2018 exchange market will see silver premiums rise by an average of 34%. According to Avalere's analysis of filings from Healthcare.gov states, exchange premiums for the most popular type of exchange plan (silver) will be 34% higher, on average, compared to last year.
Avalere experts preview the 2018 ACA open enrollment season
New analysis from Avalere finds that the administration's decision last week to end federal funding for the cost-sharing reduction (CSR) payments could lead to substantial losses for health plans-ranging from -$1.2M in North Dakota to -$200M in Florida through the end of 2017 (Figure 1).
New analysis from Avalere finds that payments to certain physician specialists could increase or decrease by as much as 16% for their 2018 performance under the Merit-based Incentive Payment System (MIPS).
Compared to beneficiaries with diabetes who are enrolled in other Medicare Advantage plans, enrollees in special needs plans experience better outcomes, after adjusting for demographic and clinical factors.