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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.
New analysis from Avalere finds that 1.2 million individuals from non-expansion states could gain Medicaid coverage in 2017 should a newly elected governor decide to expand the program.
2017 exchanges struggle to address challenges with enrollment, risk management, and consumer choice.
According to a new Avalere analysis of data from the Centers for Medicare & Medicaid Services (CMS), premiums for stand-alone prescription drug plans (PDPs) will increase and the number of PDPs available in 2017 will decrease. Conversely, the Medicare Advantage market appears strong as 8 in 10 beneficiaries have access to MA plans that offer prescription drug benefits with a zero premium.
A new analysis from Avalere finds that consumers with a range of common health conditions could reduce their spending between $8,800 and $90,020 by purchasing insurance through the Affordable Care Act (ACA).
Proposed Requirements in 21st Century Cures Act Would Increase Transparency Requirements
A new Avalere analysis finds that approximately 8 million Americans age 55 or over who are currently uninsured or have individual coverage purchased through the private market-inside and outside the exchange- could be eligible to buy-in to the Medicare program under a plan proposed by Democratic presidential candidate Hillary Clinton.
A new analysis from Avalere finds that individuals who enroll in exchange coverage during special enrollment periods (SEP) have higher costs and lower risk scores than open enrollment period (OEP) consumers.
New quality measures to address malnutrition among hospitalized older adults are now being evaluated by the National Quality Forum (NQF) for endorsement, and by the Centers for Medicare & Medicaid Services (CMS) for inclusion in their Hospital Inpatient Quality Reporting Program.
Recently, Avalere worked with the Council for Affordable Health Coverage to examine enrollment trends for the Affordable Care Act (ACA).
Avalere experts predict that one-third of the country will have no exchange plan competition in 2017, leaving consumers with few options for coverage.
In June 2016, in collaboration with FasterCures, Avalere launched the Patient-Perspective Value Framework (PPVF) Initiative to develop a value framework that appropriately incorporates the patient's perspective on value.
Since 1992, the Food and Drug Administration (FDA) has collected $7.67 billion in user fees from pharmaceutical manufacturers to fund drug reviews based on an Avalere analysis of FDA data.
Avalere experts say that the impact for most hospitals will be modest.
Katherine Steinberg comes to Avalere Health with more than 15 years’ experience in the healthcare arena.
Prescription drugs are not outsized contributors to rate increases.
The plans are waiting to see how frameworks will evolve and if physicians embrace them before relying on them to decide which prescription drugs to cover.