Linda Uwumarogie

Linda Uwumarogie supports clients with research and analysis that span a variety of healthcare sectors and stakeholders.

She applies her background in healthcare quality, health plan clinical operations, and regulatory adherence to a broad range of client projects.

Prior to joining Avalere, Linda was a Surveyor and Accreditation Manager with the National Committee for Quality Assurance, actively involved in conducting audits and supporting the development of policies and procedures for accreditation and credentialing of managed care and other healthcare related organizations. Additionally, she served as a subject-matter expert, gaining special expertise in Medicare Advantage–Special Needs Plans by working closely with the Centers for Medicare & Medicaid Services to evaluate and approve Model of Care submissions and develop Medicare Advantage Deeming Accreditation standards. 

Before that, she worked with UnitedHealthcare where she was responsible for quality-improvement-based intervention programs through design, implementation, and performance for their Medicaid population. She led clinical screening programs and community health promotion events targeted at effectively closing gaps in care and improving HEDIS results and CAHPS outcomes. While at UnitedHealthcare, Linda was also a clinical operations and regulatory adherence analyst engaged in oversight, compliance, and risk-management activities ensuring various functional areas such as utilization management, quality improvement, network management, member services, and medical management were following New York State public health laws.

Linda has an MPH from the Rutgers University School of Public Health (formerly known as the University of Medicine and Dentistry of New Jersey) and a bachelor's in biological sciences from Montclair State University.

Authored Content

Women of color are disproportionately affected by pregnancy-related death in the US, which has a higher maternal mortality rate than 10 other developed nations worldwide.

The COVID-19 pandemic has created significant challenges for all Americans, particularly for its most vulnerable populations, including the elderly and people with disabilities in Medicare. The Centers for Medicare & Medicaid Services (CMS) recently reported that 21% of fee-for-service (FFS) Medicare enrollees have stated they are forgoing non-COVID-19 related care due to the pandemic. Avalere conducted analyses to determine if a similar decrease in utilization is occurring in Medicare Advantage (MA) and assess the potential impact of deferred care on MA enrollees and plans.

On October 8, the Centers for Medicare & Medicaid Services (CMS) published their 2021 Star Ratings for Medicare Advantage (MA-PDs) and standalone Prescription Drug Plans (PDPs) on Medicare Plan Finder.

Faced with a rapidly evolving healthcare environment, there are a number of important uncertainties that commercial insurers will need to consider when planning for the future

The Center for Medicare & Medicaid Services (CMS) recently issued its proposed Notice of Benefit and Payment Parameters (NBPP) for the 2021 plan year. The proposed rule would significantly expand commercial payer flexibility to not count manufacturer copay support toward deductibles or out-of-pocket (OOP) maximums.

In the Notice of Benefit and Payment Parameters (NBPP) for the 2021 plan year, CMS questioned whether states were appropriately deciding if the state was required to defray the premium impacts of new benefit mandates added since 2011. CMS proposes requiring states to report on and justify defrayal decisions for all state benefit mandates.