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Value-Based Care

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.

Samantha Ferguson

Podcast: E3 – Start Your Day with Avalere: Translating Clinical Evidence to Value

In this third episode, Sam Ferguson, a consultant in Avalere’s Market Access practice, along with Allison Petrilla, a managing director in Avalere’s Health Economics and Advanced Analytics practice, and Amy Schroeder, a senior consultant in Avalere’s Market Access practice, discuss how stakeholders are utilizing and translating real-world evidence (RWE) into value for oncology.

Abby Moorman

NTAP Eligibility Criteria Opportunities for Inpatient Reimbursement

Recent CMS rulemaking has expanded the opportunity for new drugs and devices to achieve NTAP status, either through the traditional process or via alternative. Manufacturers that are nearing the launch of new technologies, especially in the antimicrobial space, should assess whether their technology may qualify for NTAP. Applications for NTAPs effective in FY 2022 are due this fall.

Megan Olsen

Podcast: E2 – Start Your Day with Avalere: Understanding Payment for Durable Therapies

In the second episode, Sam Ferguson and Michael Kearney, consultants in Avalere’s Market Access practice, along with Megan Olsen, an associate principal in Avalere’s Policy practice, will discuss how to appropriately define the value of durable therapies in oncology and how to pay for those therapies within our current healthcare system.

Fred Bently

Medicare Advantage and Medicaid Managed Care Growth Present Risks and Opportunities for Post-Acute Care Providers

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.

Michael Kearney

Healthcare Organizations See Reduction in ED Visits and Inpatient Admissions when Focusing on Value

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.

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