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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.
More than 40% of counties could see only one exchange plan in 2018, with risk that some counties may have no commercial options.
The number of CMS-approved QCDRs tied to payment grows by more than 60% in 2017.
Avalere experts say use of outcomes-based contracts could further goals to improve patient outcomes and manage drug costs
All 50 states and DC would receive fewer Medicaid dollars for non-disabled children.
The elimination of cost-sharing reductions could lead to low-income individuals facing higher deductibles and maximum out-of-pockets.
Today, Avalere and FasterCures published Version 1.0 of the Patient-Perspective Value Framework (PPVF).
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.
At the Asembia Specialty Pharmacy Summit 2017, an Avalere-led panel identified three focus areas for specialty pharmacies looking to achieve market leadership in an increasingly value-based care environment.
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.
Capping Medicaid funding could also shift costs to Medicare
Citing alarming statistics that show that nearly 1 of every 2 older Americans is at risk of malnutrition and that disease-associated malnutrition in older adults is estimated to cost $51.3 billion annually, a broad group of advocates laid out a roadmap for a new national effort to help millions of Americans who suffer from malnutrition or could be at risk as they grow older.
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.
Analysis shows Medicaid block grants and per capita caps could result in state budget gaps.
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).
Avalere will empower expanded insight and improvement in outcomes for value-based diabetes medications, using Inovalon’s data resources and advanced value-based care platforms.
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.
As 2017 exchange open enrollment begins, Avalere examined marketplace changes in plan choice and premiums at the county level.