Value-Based Care
Alternative payment models are becoming more advanced as the healthcare system transitions to value-based care and payers drive to accelerate generated savings. Track and stay ahead of this evolution to identify strategic partnerships and measure results.
Avalere White Paper: Value-Based Care and Orthotics and Prosthetics
A white paper explores ways in which VBC payment models can benefit from incorporating allied health domains, such as Orthotics and Prosthetics.
Health Policy Veteran Emily Donaldson Joins Avalere
Emily Donaldson brings 15 years of experience supporting pharmaceutical manufacturers and health plans, focused on insurance markets and state healthcare policy.
Medicare Cost and Utilization Across Physician Affiliation Models
An Avalere analysis assessing differences in Medicare expenditures and utilization across 4 models provides a new perspective on the evolving physician affiliation model landscape.
What’s Next for Value-Based Care in Cardiology?
The prevalence and cost of CVD make cardiology a strong candidate for value-based care. Various clinical and market trends present opportunities for continued uptake.
Video: Key NCCN Sessions Impacting Market Access to Oncology Care
In this video, Avalere market access experts discuss major takeaways from the 2024 NCCN (National Comprehensive Cancer Network) Annual Conference in the areas of reimbursement, early detection of cancer, consideration of a broader pool as provider decision makers, and patient involvement in their care decisions.
2024: An Era of Innovation and Disruption in Kidney Care
A dynamic regulatory landscape, technological advancements, and investments in R&D offer new opportunities and challenges in kidney care.
Kidney Transplantation: Current Barriers and Evolving Policies
Longstanding barriers have limited rates of kidney transplantation, but recent changes in the policy landscape may signal changes for patients and providers.
CMS Finalizes Changes to NTAP Payment Designation
The recent FY 2024 IPPS final rule revised NTAP eligibility criteria for certain technologies. Applications for the FY 2025 NTAP cycle are due by October 17, 2023.
ICER Opens Brief Comment Period on Proposed Framework Updates
ICER announced proposed changes to its Value Assessment Framework. Stakeholders have limited time to review and comment by June 30.
Video: Enhancing Oncology Model (EOM) Participation
Avalere expert Maddi Davidson discussed key EOM methods changes that will impact practice decision making.
What is the CMS Innovation Center?
The CMS Innovation Center offers policymakers a nimble, non-legislative pathway to experiment with new methods of care delivery, payment, and reimbursement in Medicare and Medicaid.
Taking Inventory: Investment Opportunities in Value-Based Care
Avalere analyzes opportunities for investment in the growing $350-billion market for population-level VBC in Medicare.
Opportunities for Savings Within Orthopedic Value-Based Bundles
It is critical for orthopedic providers to understand key cost drivers to identify opportunities for savings in bundled payment arrangements with private payers.
EOM Participation Likely Influenced by Prior OCM Experience
With EOM’s immediate downside risk, the model may appeal more to practices ready to implement care transformation activities and value-driven decision making.
EOM Model: 5 Key Considerations for Stakeholders
Stakeholders should consider how the Enhancing Oncology Model’s design and incentives will impact cancer care management and treatment selection.
Avalere Expert Commentary on CMS Enhancing Oncology Model
CMS announces long-awaited successor to the Oncology Care Model (OCM), which is scheduled to conclude on June 30, 2022.
Differential Impact on OCM Performance by Cancer Type During COVID-19 PHE
An Avalere analysis found that OCM episode spending remained below the benchmark price for prostate cancer and low-risk breast cancer during the COVID-19 public health emergency (PHE). However, spending continued to exceed the benchmark for other cancers. These patterns suggest a differential impact of the PHE on OCM performance and episode service use by cancer type.
How Healthcare Staffing Shortages Are Changing the Labor Market
A nationwide shortage of clinical and non-clinical professionals is straining the healthcare industry. Every part of the health ecosystem is making contingency plans for this ongoing and worsening labor shortage. Solutions range from traditional market approaches of wages and benefits to innovative staffing activities and advocating for policy changes.
Webinar: Navigating Value-Based Care, Defining Value, and Drug Pricing Policy
Join Avalere for a live discussion on key trends in drug pricing, value, and regulatory shifts, and how these trends will impact manufacturers.
Medicare Enrollees with COPD Compared to the General Population
The percentage of Medicare enrollees with chronic obstructive pulmonary disease (COPD) in Medicare Advantage (MA) plans is growing (3.1% growth projected between 2020 and 2030), but the majority (60%) of enrollees with COPD are in fee-for-service (FFS) Medicare. Compared to the general FFS Medicare population, more beneficiaries with COPD are dual eligible for Medicaid and fewer beneficiaries with COPD have employer sponsored insurance as a source of supplemental coverage.