Lance Grady

Lance Grady devises commercialization strategies focused on value, access, and reimbursement.

With a focus on oncology and over 20 years of experience in policy, access,  reimbursement strategy and execution, and point-of-care, he is passionate about providing practical and meaningful solutions that are viable to all healthcare stakeholders. Lance delivers proven, measurable outcomes by creating integrative and sustainable solutions in functional areas pertaining to: patient access strategy and services; physician-administered reimbursement strategy and support; value-based and risk-based payment models; CMS policy strategy; Medicare payment models; commercial health plan formulary, medical policy, and utilization management; benefit design; drug-dollar-data flow; oncology pathways; specialty channel strategies—pharmacy, GPO, and wholesaler distribution.

Prior, Lance enjoyed a successful 12-year career at Bristol-Myers Squibb in various leadership roles in U.S. Market Access. He also has experience in orphan drug and autoimmune therapeutic markets.

He is a graduate of the University of Louisiana-Monroe where he studied human biology and immunobiology.

Authored Content

New Avalere analysis finds that practices currently participating in the Oncology Care Model (OCM) would be more likely to receive a Novel Therapy Adjustment (NTA) in the newly proposed Oncology Care First (OCF) Model.

A new Avalere analysis finds that oncology practices participating in the Oncology Care Model (OCM) treated patients with 2–3% higher Medicare costs per episode, on average, than OCM prediction model estimates during the first two performance periods.

Pressure to lower costs will increase for OCM providers as CMS pushes to 2-sided risk.

Ahead of the American Society of Clinical Oncology's annual meeting, Avalere experts discussed the latest trends in policy, reimbursement, and market access reshaping oncology care.

Recent developments in the specialty pharmaceutical marketplace merit distinct attention from manufacturers.

The interaction of recently announced drug pricing reforms will have differential implications for stakeholders.

The swift proposed implementation timeline will require stakeholders to evaluate quickly operational requirements, behavioral responses, cross-program implications, and impact on contractual arrangements.

Yesterday, the Department of Health and Human Services Office of Inspector General released a proposed rule redefining the current safe harbor for pharmaceutical manufacturer discounts and rebates to entities like health plans and pharmacy benefit managers (PBMs).

Avalere experts examine the current drug pricing policy landscape and what potential changes stakeholders should prepare for.

Reforms to “eliminate rebates” could have varying impacts based on features of their design.