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Tiernan Meyer

Tiernan Meyer supports Avalere clients in analytic and strategic engagements focused on Medicaid, Medicare Part D, state health policy trends, and the impact of federal health reform.

In her role at Avalere, she has worked with stakeholders across the healthcare industry, including health plans, pharmaceutical manufacturers, pharmacies, wholesalers, associations, and patient groups.

Tiernan leads much of Avalere’s Medicaid work focused on policy, market research, and strategic analysis. This includes analysis of Medicaid trends and enrollment, state- and payer-level Medicaid strategy, policy design and engagement strategy, and Medicaid-related data analysis. Her work aims to help clients understand the business impact of Medicaid policy decisions and to strategize solutions to improve beneficiary access to care. She has particular expertise in pharmaceutical management trends, innovative contracting for prescription drugs, and cost containment.

Prior to joining Avalere, Tiernan worked as a health educator at the Delta Area Health Education Center in Helena, AR, and analyzed the Chilean public healthcare system while studying in Concepción, Chile.

Tiernan has a BA in neuroscience from Middlebury College.

Authored Content


CMS proposes to alleviate drug price reporting barriers that have hindered the adoption of innovative contracting models for prescription drugs. Stakeholders should contemplate the details and implications of CMS’ proposals—including how the changes would impact current contracting—as well as remaining areas of ambiguity.

State Medicaid programs face a series of near- and long-term challenges amid the COVID-19 pandemic due to enrollment growth and financial pressures. Stakeholders should evaluate key drivers shaping the state-by-state Medicaid outlook.

On February 27, Avalere experts discussed the latest policy, pricing, and reimbursement challenges for prescription drugs in Medicaid in the “What’s Next for Medicaid Drug Pricing?” webinar. They reviewed the ways prescription drugs are managed in Medicaid, what innovative medicines may mean for the program, and potential implications of CMS’ Healthy Adult Opportunity (HAO).

View the webinar recording to learn more about the latest policy, pricing, and reimbursement challenges in Medicaid.

New analysis from Avalere finds that states currently covering non-mandatory adult populations who choose to participate in the Healthy Adult Opportunity (HAO) initiative may need to generate up to 8% in Medicaid savings to keep spending below new capped funding levels.

The Centers for Medicare & Medicaid Services (CMS) announced the Healthy Adult Opportunity, a new Section 1115 demonstration initiative allowing states to shift toward capped Medicaid financing models with an opportunity for shared savings. If the option is chosen by states, it could be the largest change to Medicaid since the ACA.

CMS’s Healthy Adult Opportunity program, a new Section 1115 demonstration initiative, will allow state Medicaid programs to move toward capped financing models for some non-disabled adult beneficiaries with an opportunity for shared savings and additional flexibilities.

Avalere analysis finds that tying Medicare Part D manufacturer discounts to utilization in the catastrophic phase instead of in the coverage gap would have differential impacts by disease area.

Avalere analysis finds that a larger proportion of beneficiaries taking a Part D cancer therapy reached catastrophic compared to all Part D enrollees.

New research from Avalere finds that capped funding policies could reduce federal funding to states, specifically for children, by $89B to $163B nationally for FY 2020–2029.

As policymakers increasingly consider policy options to reform Medicare Part D and reduce program expenditures, an Avalere analysis examines spending across classes with various availability of brand and generic drugs.

On April 5, CMS issued guidance announcing a voluntary, 2-year demonstration that would modify the Part D risk corridors if the proposed rule to revise the Anti-Kickback Statute safe harbors is effective for 2020.

Tune in for episode 2 of our mid-term elections podcast. Avalere experts, Chris Sloan and Tiernan Meyer, discuss potential state and federal-level scenarios for Medicaid expansion.

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

On June 27, CMS notified Massachusetts of a partial approval of the MassHealth program’s proposed 1115 waiver request.

On March 6, Avalere experts came together to discuss the latest Medicaid developments.

Avalere experts discuss an evolving Medicaid program supported by a new administration and novel state approaches.

Beneficiaries show signs of pent-up demand with acute healthcare needs early in their enrollment, but over time costs increase substantially and shift toward chronic care.

New analysis from Avalere finds that the Graham-Cassidy-Heller-Johnson (GCHJ) bill to repeal and replace the Affordable Care Act (ACA) would lead to a substantial reduction in federal Medicaid funding to states of $713B through 2026 and more than $3.5T over a 20-year period if block grant funding is not reauthorized (Figure 1).

The Better Care Reconciliation Act (BCRA) would cap Medicaid funding to states. In this analysis, Avalere worked with The SCAN Foundation to examine how BCRA Medicaid changes would impact dual-eligible beneficiaries. We compare these outcomes to the impact of the House-approved American Health Care Act.

New analysis from Avalere finds that states could see federal funding for their Medicaid programs decline by between 6% and 26% under the Better Care Reconciliation Act (BCRA) by 2026.

Across 8 therapeutic areas, the Veteran's Administration (VA) National Formulary covers 49 percent fewer drugs than Ohio's largest Medicaid managed care plan and 68 percent fewer drugs than the Ohio Medicaid preferred drug list (PDL).

Capping Medicaid funding could also shift costs to Medicare

Analysis shows Medicaid block grants and per capita caps could result in state budget gaps.

While 31 states and DC expanded Medicaid under the ACA, the future of expansion is uncertain.

New analysis from Avalere finds that 1.2 million individuals from non-expansion states could gain Medicaid coverage in 2017 should a newly elected governor decide to expand the program.

28 States & DC Are Expanding Medicaid Eligibility; Others May Decide to Expand

28 States & DC Are Expanding Medicaid Eligibility; Others May Make Decisions to Expand.

In at least six states, Medicaid programs could be expanded as a result of the outcome of the 2014 governors' races.

Over 550K New Medicaid Enrollees Gained Coverage in Non-Expansion States in First Quarter.

On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released updated estimates on health insurance coverage provided through the ACA.

700K to 1.3M Additional Medicaid Enrollees through March, If Current Trends Continue.