The healthcare system is transitioning to value-based care. We can help you navigate the alphabet soup: APM, ACO, MSSP, EPM, MACRA, OCM, OBC. Count on us to guide you through the transition.
Avalere experts discussed the latest policy, reimbursement, and program changes affecting post-acute care and why they matter.
The payer landscape continues to evolve for post-acute care (PAC) providers. Fueled by lower annual costs and expanded benefit options relative to the Medicare fee-for- service (FFS) program, Medicare Advantage (MA) is growing rapidly, now encompassing more than one-third of all Medicare beneficiaries. At the same time, nearly half the states have implemented managed care plans to provide Medicaid long-term care benefits.
Avalere’s analysis found that hospice patients diagnosed with cardiovascular and dementia conditions represent the largest proportion of “live discharges” compared to patients with other conditions.
Skilled nursing facilities (SNF) nationwide continue to adapt to the Patient-Driven Payment Model (PDPM), a transformational new approach to SNF Medicare reimbursement that took effect October 1, 2019.
Avalere worked with a healthcare organization to assess the impact of their quality improvement program over a 4-year period. The organization prepared primary and specialty care providers/practices to transition from fee-for-service (FFS) to value-based payment arrangements. Avalere’s analysis found participation in the program led to a reduction in both emergency department (ED) visits as well as inpatient (IP) admissions over the period reviewed.
Despite the oft-repeated mantra that provider collaboration and care coordination are the bedrock of a more rational and cost-effective healthcare system, relationships between hospitals and post-acute care providers remain largely fragmented and uncoordinated.
Announced this past August, the US Preventive Services Task Force (USPSTF) expanded risk assessment and genetic testing recommendations for BRCA-related cancers and recommendations for risk-reducing therapies. This expansion marks the growing importance of genetic literacy in the healthcare system.
ICER is eager to position itself as the primary comparative and cost-effectiveness research body in the US. While their activity has been traditionally more limited to product-specific reviews, the Institute is increasingly looking to shape the broader debate around value and drug pricing.
Medicare ACOs continue to realize experience-level results.
For the last several years, Avalere has worked with the Alliance for Home Health Quality and Innovation (AHHQI) to analyze the ever-changing home health landscape.
While emerging blockchain technology is expected to impact a range of businesses in the years ahead, its strengths seem particularly well suited for the complex data-sharing demands of the pharmaceutical and healthcare industries.
Cost savings and improved clinical outcomes cited as top advantages for payers according to survey conducted by Avalere Health.
Manufacturers currently face an almost-unprecedented level of uncertainty in developing contracting strategies for the coming plan years. Avalere’s combination of policy and commercialization expertise, paired with its data capabilities, allow us to support life sciences companies understand this challenging landscape to ensure access to innovative therapies for their patients.
Additional Medicare payment options available for new, high-cost technologies used in the inpatient setting.
Avalere will serve as the RWJF Health Systems Transformation Research Coordinating Center to meet patients’ interrelated clinical and social needs.
Announced in late April, the Center for Medicare & Medicaid Services’ (CMS) Primary Care First initiative marks a critical step forward in the long and complex journey toward a fundamentally transformed healthcare system.
Avalere experts published a supplement in the June 2019 American Journal of Managed Care entitled “Ensuring Appropriate Access to Pulmonary Arterial Hypertension Therapy.”
Dr. Roy Beveridge and Mike Schneider Join the Firm
In January 2018, Avalere Health partnered with the Society of Cardiovascular and Angiography Interventions to launch the development of the Heart Valve Initiative.
Paper details recent developments in leading value frameworks, including Avalere’s Focus on Patient Orientation in Value Assessment.