States are taking center stage when it comes to developing novel policy approaches. Avalere’s team tracks and analyzes developments related to Medicaid expansion, individual market and exchanges, drug pricing, and other emerging trends. We can help you succeed in this dynamic marketplace.
Tune in for episode 2 of our mid-term elections podcast. Avalere experts, Chris Sloan and Tiernan Meyer, discuss potential state and federal-level scenarios for Medicaid expansion.
New analysis from Avalere finds that 2.7 million individuals from states that have not expanded Medicaid could gain Medicaid coverage should their newly elected governors decide to expand the program or states pass expansion referenda on their ballots.
On September 22, California became the sixth state to limit or ban short-term limited-duration insurance (STLDI) plans.
On June 27, CMS notified Massachusetts of a partial approval of the MassHealth program’s proposed 1115 waiver request.
Maine had the greatest decline at 25% compared with the national average of 11%.
On March 6, Avalere experts came together to discuss the latest Medicaid developments.
Avalere experts discuss an evolving Medicaid program supported by a new administration and novel state approaches.
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.
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.
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.
The Better Care Reconciliation Act (BCRA) would cap Medicaid funding to states. In this analysis, Avalere worked with The SCAN Foundation to examine how BCRA Medicaid changes would impact dual-eligible beneficiaries. We compare these outcomes to the impact of the House-approved American Health Care Act.
Across 8 therapeutic areas, the Veteran's Administration (VA) National Formulary covers 49 percent fewer drugs than Ohio's largest Medicaid managed care plan and 68 percent fewer drugs than the Ohio Medicaid preferred drug list (PDL).
All 50 states and DC would receive fewer Medicaid dollars for non-disabled children.
Capping Medicaid funding could also shift costs to Medicare
Analysis shows Medicaid block grants and per capita caps could result in state budget gaps.
While 31 states and DC expanded Medicaid under the ACA, the future of expansion is uncertain.
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.
Popular low cost options see smaller increases.
The CalPERS Basic Plan Drug List, which is the formulary for all California public employees, includes 222 brand drugs and 287 generic drugs. In contrast, drug coverage in the Veterans Administration (VA) and Medi-Cal (California's Medicaid program) is far more limited than the CalPERS drug list.
Believing that states are productive incubators of innovation, the Center for Medicare & Medicaid Innovation (CMMI) launched a State Innovation Model (SIM) grant program in 2013 to encourage state-by-state testing of innovative payment and delivery models.