Meet
Robin Duddy-Tenbrunsel

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

March 18, 2020 | Insights & Analysis > Federal Policy

Over 1 Million MA Enrollees Are in Plans Offering New Benefits for the Chronically Ill in 2020
Medicare Advantage (MA) plans are using new flexibilities to provide additional supplemental benefits to beneficiaries with chronic illnesses.
March 5, 2020 | Insights & Analysis > Federal Policy

CMS Proposed Changes to MA D-SNP Look-Alikes May Especially Impact Duals in CA MA Plans
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.
February 3, 2020 | Insights & Analysis > Federal Policy

What to Watch for in this Week’s Call Letter and Proposed MA-PD Rule
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.
December 11, 2019 | Insights & Analysis > Federal Policy

Assessment of Regulatory Proposal to Eliminate the FFS Adjuster from Medicare Advantage Plan Audits
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.
December 9, 2019 | Insights & Analysis > Federal Policy

Medicare Advantage Plans May Be Paid Below Actual ESRD Patients’ Costs in Large Metropolitan Areas in 2021
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.
August 21, 2019 | Insights & Analysis > Federal Policy

Impact of Proposed CMS Methodology for Calculating Payment Errors May Vary Based on Plan Enrollee Characteristics
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.
July 1, 2019 | Insights & Analysis > Drug Pricing

Over Half of Medicare Advantage Beneficiaries Enrolled in Plans that Require Step Therapy for New Starts of Part B RA Biologics in 2019
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.
March 18, 2019 | Insights & Analysis > Federal Policy

CMS Methodology for Calculating Payment Errors May Result in Underpayments to Health Plans
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.
February 25, 2019 | Insights & Analysis > Federal Policy

Uses and Limitations of Medicare Advantage Encounter Data
In a recent post on the Health Affairs Blog, we examine the potential uses and limitations of Medicare Advantage (MA) encounter data.
January 15, 2019 | Insights & Analysis > Drug Pricing

Drug Importation Proposals Gain Traction but Raise Cost and Operational Questions
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.
September 10, 2018 | Insights & Analysis > Drug Pricing

Key Considerations for Medicare Advantage Plans Evaluating New Part B Step Therapy Flexibility
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.
June 14, 2018 | Insights & Analysis > Social Determinants of Health

CMS Expands Benefit Flexibilities in Medicare Advantage
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.
September 6, 2016 | Insights & Analysis > Federal Policy

CMS Takes on Risk Adjustment in Latest NBPP Proposal
In late August, CMS released its proposed Notice of Benefit and Payment Parameters (NBPP) for the 2018 plan year.
March 24, 2016 | Insights & Analysis > Federal Policy

Changing the Way Insurers are Paid Could Increase Stability in the Exchange Market and Beyond
New Avalere report identifies opportunities to refine the risk-adjustment model that could improve the way Affordable Care Act plans are paid
March 16, 2016 | Insights & Analysis > Federal Policy

More than 70 Percent of Medicare Advantage Enrollees in Plans with Four or More Stars
Percentage of Medicare Advantage enrollees in plans with at least four stars continues to grow.
January 26, 2016 | Press Releases > Federal Policy

Nearly 60 Percent of New Medicare Advantage Plans Are Sponsored by Healthcare Providers
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.