Meet
Erica Breese

Erica Breese advises clients on developments and trends in the acute and post-acute healthcare sectors and helps them navigate reforms in payment and delivery models, such as bundled payments and accountable care organizations.

She assists clients in understanding their strategic opportunities in response to changing market dynamics as well as legislative and regulatory reforms.

Prior to joining Avalere, Erica was special assistant to the director, CMS Office of Information Products and Data Analytics, where she managed policy development and drafting of the Physician Payments Sunshine Act regulations. She also has experience in CMS’ Office of Policy, identifying performance trends in Medicare spending and utilization statistics. Prior to this, as a program coordinator at George Washington University’s Department of Health Policy, she was responsible for operational oversight of projects for the DC Medicaid agency and the STOP Obesity Alliance.

Erica has an MBA from the University of Virginia and a BS in neuroscience and behavioral biology from Emory University.

Authored Content


Check out the second episode of our series on new supplemental benefits offered through Medicare Advantage plans for 2019 where Kenny Kan and Erica Breese discuss the "rule of 8".

Majority of hospitals in BPCI Advanced, the second iteration of CMS’ largest bunded payment initiative, have no prior experience with risk in the original BPCI program.

In August 2018, CMS is expected to finalize a proposed new payment methodology for skilled nursing facilities (SNFs) that would shift the focus from resource use to patients’ clinical needs.

As the deadline approaches for providers to make decisions on their participation in BPCI Advanced, Avalere analysis shows that certain conditions may provide greater opportunity for success.

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.

On April 24, 2018, Avalere experts were joined by Aledade CEO, Farzad Mostashari, MD, to discuss the latest developments coming out of the Center for Medicare & Medicaid Innovation (CMMI).

Avalere experts are joined by Aledade CEO, Farzad Mostashari, MD, discussing the latest developments coming out of the Center for Medicare & Medicaid Innovation (CMMI).

New research from Avalere finds Medicare beneficiaries are spending fewer days in skilled nursing facilities (SNFs) since 2009 on a per capita basis.

On February 9, the Senate voted to pass the Bipartisan Budget Act of 2018, which funds the government through March 23, lifts spending caps for 2 years, and suspends the debt ceiling until March 2019.

Last month, the Centers for Medicare & Medicaid Services (CMS) released a Request for Application (RFA) for the Bundled Payment for Care Improvement (BPCI) Advanced initiative.

With applications for the new Bundled Payment for Care Improvement (BPCI) Advanced initiative due on March 12, providers have a short window to act.

The Centers for Medicare & Medicaid Services (CMS) have released a Request for Application (RFA) for the Bundled Payments for Care Improvement (BPCI) Advanced Initiative.

Learn more about how new models of care are impacting providers as Avalere experts discuss care coordination and care transitions.

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.

Watch Erica Breese, our post-acute care expert, preview how analytics can reduce readmissions and improve outcomes for patients after hospitalizations.

Today, the Centers for Medicare & Medicaid Services took another step in shifting Medicare to a value-based payment model that rewards hospitals for delivering better care at a lower cost.

Avalere recently partnered with the Alliance for Home Health Quality and Innovation (AHHQI) to explore the topic of the future of home health care.

Avalere recently partnered with the Physicians Advocacy Institute to examine trends in physician employment and practice ownership by hospitals and health systems from 2012 to 2015.

Recently, Avalere partnered with the Alliance for Home Health Quality and Innovation to better understand how home healthcare is currently being used and how it will be used in the future for older Americans and Americans with disabilities.

In our final bundled payment podcast, Avalere's Adam Borden discusses how the potential updates may impact device manufacturers.

In the third podcast in our bundled payment series, Avalere's Mary Ann Clark discusses how the potential updates may impact device manufacturers.

In episode 2 of our bundled payment podcast series, Avalere's Sally Rodriguez shares how the potential updates may impact post-acute care providers.

Avalere experts say that the impact for most hospitals will be modest.

Our experts share the lessons that we’ve learned from our extensive experience with the Bundled Payments for Care Improvement Initiative. The Bundled Payments for Care Improvement demonstration is a voluntary program sponsored by CMMI in which hospitals, physician group practices, and post-acute care providers accept clinical and financial risk for patients over specified episode time frames post-hospital discharge.

In order to better coordinate care across the care continuum, CMS is allowing hospitals to establish “CJR Collaborators” or other providers that share risk with the participating hospital. Listen as Fred Bentley and Erica Breese discuss the details.

The Medicare Access and CHIP Reauthorization Act (MACRA) passed last spring is transforming physician payment and standardizing requirements for APMs. ​Listen as Adam Borden and Jared Alves cover Advanced APMs, incentives CMS offers for providers to participate in APM, and the exclusion of specific tracks.

With the launch of the Comprehensive Care for Joint Replacement (CJR) model on April 1, CMS has ushered in a new phase for payment reform. Under this mandatory program, roughly 800 hospitals across the U.S. will assume financial accountability for the cost of all services provided to Medicare patients during 90-day care episodes for hip and knee replacements.

Hospitals should focus on care after discharge, which drives more than 39 percent of spending.

According to a new analysis by Avalere, total profit margins for freestanding skilled nursing facilities (SNFs) in Pennsylvania decreased 28 percent between fiscal years (FY) 2007 and 2014, from 3.2 percent to 2.3 percent.

A new analysis by Avalere examines differences in Medicare spending for episodes of care before and after cardiovascular imaging, colonoscopy, and evaluation and management services. Avalere applied a risk adjustment methodology to account for differences in patient demographics and patient severity across settings. The findings suggest when care is initiated in the typically higher-paying HOPD setting than in physicians' offices and ambulatory surgical centers, the services that follow also result in higher spending relative to when care is initiated in the office setting.

As risk shifts, so too does the responsibility for delivering high-quality outcomes at lower costs. In this podcast, listen in as Sally Rodriguez discusses the impact of this shift and the momentum surrounding delivery models. Sally explores what’s ahead for this changing landscape and the opportunities that await.