Robin Duddy-Tenbrunsel analyzes the implications of health reform and applies her background with the health insurance exchanges, evidenced-based policy, and the federal budget process to providing strategic advice to clients on their policy and advocacy priorities.
Prior to joining Avalere, Robin worked in the Pay for Success field, where she researched cost-saving, evidenced-based health interventions. She also interned at the Office of Management and Budget’s Health Division, analyzing Health and Human Services data as part of the budget approval process and assisting with the preparation of OMB recommendations. Additionally, she has internship experience with the Kaiser Family Foundation, where as a member of the Healthcare Marketplace Team, she co-authored a paper on 2015 premium changes on the Affordable Care Act’s Healthcare Marketplace.
Robin has an MPP from Georgetown University’s McCourt School of Public Policy and a BA from Tufts University.
Authored Content
As the Centers for Medicare & Medicaid Services (CMS) consider what, if any, changes to propose to Medicare Advantage (MA) through fall rulemaking, stakeholders should consider where the Biden administration’s priorities may differ from the previous administration’s. Topics that may be addressed—either in regulation or via legislation—include health equity, supplemental benefit flexibility, star ratings, payment and risk adjustment, and end-stage renal disease (ESRD).
Digital health will continue to be a focus under recently confirmed Secretary Becerra‘s leadership at the Department of Health and Human Services. As the Biden administration looks to enforce compliance across a range of data interoperability and price transparency rules, as well as usher in new Food & Drug Administration (FDA) and Centers for Medicare & Medicaid Services (CMS) coverage policies for medical technologies and digital health tools, the industry is responding with a range of innovations.
At a time when more Americans—particularly people of color—are enrolled in Medicaid, new Avalere analysis finds that provider networks for primary care and certain specialties in Medicaid are narrower on average than those of commercial plans in certain metropolitan areas, ranging from 63% smaller in Miami to 18% in New York.
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.
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.
Avalere analysis finds End Stage Renal Disease (ESRD) spending in Puerto Rico varies substantially, and most spending is related to outpatient dialysis and inpatient services.
Avalere analysis finds that at least 5 million Black and Hispanic people may lose their health insurance as a result of the pandemic.
Dually eligible beneficiaries in Pennsylvania with end-stage renal disease (ESRD) are more often people of color and have higher costs compared to non-duals, but their utilization patterns are similar.
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.
Deferral of care during the COVID-19 pandemic is resulting in fewer claims and diagnoses among Medicare Advantage (MA) enrollees, which could lead to a 3%–7% reduction in 2021 risk scores and lower plan payments in 2021.
The COVID-19 pandemic will have ongoing, market-wide implications as Medicare Advantage (MA) plans contend both with responding to the virus and the disruption to their normal activities.
Medicare Advantage (MA) plans are using new flexibilities to provide additional supplemental benefits to beneficiaries with chronic illnesses.
Avalere analysis finds that many CA beneficiaries enrolled in D-SNP look-alike plans may not be able to a transition to a D-SNP.
CMS is set to release its annual proposed changes to Medicare Advantage (MA) this week. Some of the topics that may be addressed include End-Stage Renal Disease (ESRD), network adequacy requirements, payment to MA plans that offer the hospice benefit, and the MA quality bonus program.
In a recent post on the RISE website, Sean Creighton examines the methodology and evidence behind CMS’s proposal to eliminate the Fee-for-Service (FFS) Adjuster from Risk Adjustment Data Validation (RADV) audit methodology.
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.
In 2018, CMS proposed to revise its Risk Adjustment Data Validation (RADV) methodology to exclude the FFS Adjuster in its payment recoupment calculations. New analysis from Avalere finds that the payment impact associated with fee-for-service (FFS) Medicare coding discrepancies would be greater for certain subgroups of beneficiaries (e.g., dual-eligible, those with certain common and potentially serious health conditions) enrolled in the MA program.
Avalere analysis of 1,375 Medicare Advantage plans’ 2019 medical benefit drug coverage policies finds that 672—covering approximately 14.3 million lives—apply step therapy to at least 1 of the rheumatoid arthritis biologic drugs covered under Medicare Part B in 2019.
In February 2012, the Centers for Medicare & Medicaid Services (CMS) announced a final payment error calculation methodology for its contract-level Risk-Adjustment Data Validation (RADV) audits of Medicare Advantage (MA) plans.
In a recent post on the Health Affairs Blog, we examine the potential uses and limitations of Medicare Advantage (MA) encounter data.
The costs of ensuring the safety and efficacy of imported drugs and preventing the entry of counterfeit products are among the many factors that must be weighed against any potential savings from a drug importation program.
Following its recent announcement to grant Medicare Advantage (MA) plans the flexibility to use step therapy techniques for Part B drugs beginning in January 2019, the Centers for Medicare & Medicaid Services (CMS) released an FAQ with additional guidance on its implementation.
Earlier this year, the administration granted Medicare Advantage plans greater flexibility to target benefit designs for individuals with certain high-risk health conditions. These changes are expected to position the program for continued growth.
In late August, CMS released its proposed Notice of Benefit and Payment Parameters (NBPP) for the 2018 plan year.
New Avalere report identifies opportunities to refine the risk-adjustment model that could improve the way Affordable Care Act plans are paid
Percentage of Medicare Advantage enrollees in plans with at least four stars continues to grow.
A new analysis from Avalere Health finds that hospitals and health systems are increasingly taking risk for the cost of Medicare patients and the quality of the care they receive.