Richard Hughes IV

Richard Hughes IV provides strategic counsel to clients navigating a complex health regulatory and policy environment and leads teams to develop and support client policy and business strategy.

He has special expertise in the areas of vaccines and population health, state health policy and the Affordable Care Act.

Prior to joining Avalere, Richard practiced with the Washington law firm Epstein Becker Green, where he advised health care entities on a range of legal, regulatory and policy matters. His previous roles include associate director of Policy with Merck & Co, Inc., director of State Health Policy with the Association of State and Territorial Health Officials, and gubernatorial appointee to the Arkansas State Board of Health.

Richard earned his JD from The George Washington University Law School and an MPH from the University of Arkansas for Medical Sciences. He is a professorial lecturer in health policy and management at The George Washington University. Richard is a member of the District of Columbia Bar and the national Delta Omega Honorary Society in Public Health.

Authored Content

New research from Avalere finds that the provision of pneumococcal conjugate vaccines increased immediately after ACIP’s 2014 recommendation to add the vaccine to the routine immunization schedule for older adults.

Nearly 80,000 people died during the 2017–2018 influenza season. Only 37% of adults were vaccinated. Several novel emerging products could make vaccination more accessible and effective, potentially reshaping the market and lowering influenza disease burden.

Ambiguous recommendations for preventive services are causing confusion among plans and providers on the clinically recommended preventive services that should be covered without cost sharing. A recent USPSTF recommendation on HIV prevention offers an opportunity to urge a recommending body to provide further clarity in its recommendation. Comments are due December 26.

On September 22, California became the sixth state to limit or ban short-term limited-duration insurance (STLDI) plans.

New research shows higher cost sharing for vaccines under Part D leads to fewer seniors getting vaccines. Immunization rates are higher for vaccines covered by Part D plans with lower cost sharing.

On June 14, Avalere experts came together with Cynthia Tudor, former Deputy Center Director of the Center for Medicare and Senior Advisor to Avalere, to discuss vaccine coverage and access challenges under Medicare.

Avalere experts discuss adult immunization rates in the United States and how the disparate coverage of vaccines under Medicare creates significant barriers to increasing adult immunization uptake.

States can pursue various policy opportunities to encourage vaccination and increase access to vaccines.

Quality measurement in the adult vaccine space has evolved rapidly. Recent advancements continue to propel efforts to drive adult immunization uptake.

Coordinated information sharing can facilitate the delivery of integrated care to patients using both physical and behavioral health services.

Avalere has released a new white paper explaining the current insurance coverage requirements for vaccines and the laws that govern those requirements for the Medicare (Parts B and D), Medicaid, and commercial (group and individual) markets.

A new analysis by Avalere finds that, despite efforts by policymakers to encourage broader vaccination rates, Medicare enrollees have limited access to a set of 10 recommended vaccines without having to pay out-of-pocket (e.g., co-payments).