Joanna Young

Joanna Young provides clients with data-driven policy analysis using her quantitative skills, modeling expertise, and knowledge of Medicare and other public health insurance programs.

Joanna creates analytical models that support analysis of the policy impact on different business lines and the overall healthcare market. Her work includes assessments of impact on covered lives and federal budgetary costs and savings associated with proposed legislative changes. She also focuses on data and policy analysis for pharmaceutical products, including the 340B Drug Pricing Program as well as market access, reimbursement, and commercialization issues.

Prior to joining Avalere, Joanna worked at Integrity Management Services, where she designed and conducted analytics in support of the Centers for Medicare & Medicaid Services' program integrity efforts to combat fraud and assure compliance in the Medicare and Medicaid programs.

Joanna has an MPP with a concentration in healthcare policy and statistics from The College of William and an MA and BA in sociology from the University of Warsaw's Institute of Applied Social Sciences in Poland.

Authored Content

With Congress likely to consider a second reconciliation bill in the near future that may include various drug-pricing and Medicare Part D reform policies as spending offsets, an updated Avalere analysis examines spending across classes with various availability of brand and generic drugs.

A new analysis from Avalere estimates the impact of reverting back to the Calendar Year (CY) 2017 Medicare Outpatient Prospective Payment System (OPPS) payment policy that reimbursed all separately payable drugs at average sales price (ASP) plus 6%. Key findings suggest beneficiary cost sharing for separately payable drugs at 340B OPPS hospitals would increase by $472.8 million. Also, 82% of all OPPS hospitals—specifically 89% of rural, 80% of urban, and 49% of 340B hospitals—would see net total payment decreases.

Avalere analysis finds healthcare utilization among Medicare Fee-for-Service (FFS) beneficiaries decreased in the spring of 2020 compared to the spring of 2019.

Over 3 million Medicare Advantage (MA) beneficiaries are enrolled in plans providing additional supplemental benefits to individuals with chronic illnesses, compared to just over 1 million in 2020.

Globally and in the US, widespread vaccination has demonstrated medical, economic, and social value to both individuals and public health and has contributed to reductions in morbidity and mortality of certain diseases.

Avalere analysis finds hospitals would receive higher additional payments from Medicare through the New COVID-19 Treatment Add-on Payment (NCTAP) compared to the New Technology Add-on Payment (NTAP).

Medicare Advantage (MA) plans continue expanding coverage of supplemental benefits, including services related to the pandemic.

Therapies currently being developed to treat COVID-19 in the inpatient setting have opportunity for additional Medicare reimbursement.

On August 25, “Calcimimetic Use in Dialysis-Dependent Medicare Fee-for-Service Beneficiaries and Implications for Bundled Payment” was published in Kidney 360. The article featured research and analytics conducted by Avalere experts.

Avalere continues to find a significant drop in utilization of key physician-administered therapies in 2020 relative to 2019.

With the release of the 2021 Medicare Advantage (MA) and Part D Final Rule, the details of the upcoming policy change that allows beneficiaries with end-stage renal disease (ESRD) to enroll in MA are set. Stakeholders need to adapt quickly to be prepared.

Avalere analysis of Medicare fee-for-service (FFS) hospital stay claims with associated COVID-19 diagnoses finds that total US healthcare system costs for hospitalizations due to COVID-19 could range from $9.6B to $16.9B in 2020.

Recent Avalere analysis finds decreases in utilization of oncology and autoimmune treatments across all care settings since the onset of the health crisis.

Over half of counties in the US (52%) do not have any mental healthcare providers.

Avalere analysis of the distribution of provider relief funds indicates geographical concentration related to the number of reported COVID-19 cases.

As COVID-19 deaths increase, the FDA is evaluating and considering approval of treatments more quickly, but the rush to find treatment options is creating new access considerations for patients and providers.

Avalere analysis finds that new users account for a large share of Medicare spending on opthalmic medications.

Medicare Advantage (MA) plans are using new flexibilities to provide additional supplemental benefits to beneficiaries with chronic illnesses.

Avalere analysis finds differences in the demographics of patients with End Stage Renal Disease (ESRD) enrolled in Medicare Advantage (MA) compared to ESRD patients in Fee-for-Service (FFS) Medicare

Avalere analysis finds that out-of-pocket (OOP) spending on prescription drugs for beneficiaries with multiple sclerosis (MS) could be as high as one third of their income.

According to a new analysis from Avalere, Medicare Part D beneficiaries who are taking mental health drugs and do not receive low-income cost-sharing support are responsible for a higher share of the cost of mental health drugs (46%) than for non-mental health drugs (23%).

According to a new analysis from Avalere, Medicare Part D plans place generic prescription drugs on non-generic tiers 53% of the time in 2020.

New analysis from Avalere finds 52% of Part D plans achieve generic substitution1 rates above 75%.

Avalere worked with a healthcare organization to assess the impact of their quality improvement program over a 4-year period. The organization prepared primary and specialty care providers/practices to transition from fee-for-service (FFS) to value-based payment arrangements. Avalere’s analysis found participation in the program led to a reduction in both emergency department (ED) visits as well as inpatient (IP) admissions over the period reviewed.

Avalere analysis finds that payment to Medicare Advantage (MA) plans for end-stage renal disease (ESRD) patients in highly populated regions may be significantly below actual patient costs.

Medicare Advantage (MA) plans continue expanding coverage of supplemental benefits following administration’s policy changes from a year ago.

As policymakers consider reforms to the Part D benefit to address rising out-of-pocket (OOP) costs by adding a maximum OOP cap, an Avalere analysis examines the types of beneficiaries mostly likely to be helped by such a policy.

New Avalere analysis finds that shifting Part B-covered rheumatoid arthritis (RA) drugs to Part D benefit would increase the share of prescriptions occurring in the catastrophic phase for impacted beneficiaries by more than 5 times.

As policymakers increasingly consider policy options to reform Medicare Part D and reduce program expenditures, an Avalere analysis examines spending across classes with various availability of brand and generic drugs.

In a new analysis, Avalere examines the implications of CMS’ potential new requirement that Part D plans place generics only on generic tiers.

New Avalere research finds high utilization of generic medications in the 6 protected drug classes under Part D.

MA plans expand coverage of supplemental benefits following administration’s policy change.

Avalere examines the effect of foundation-sponsored financial assistance on out-of-pocket costs and federal spending.

Rural hospitals will see an average 2.7% net increase of Part B payments.

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%.

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 Health estimates that three proposed policy changes to expand Medicare reimbursement of telehealth and remote patient monitoring (RPM) would collectively decrease federal spending by $1.8 billion between FY2017 and FY2026.