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.
Featured Content
Podcast: Clinical Pathways in Oncology, Part 1
Tune into another episode of Start Your Day with Avalere. In this segment, experts from Avalere’s Market Access practice discuss clinical pathways as they relate to value in oncology.
Webinar: Market Access Enablement Strategies, Part 2: Navigating Policy and Marketplace Developments
Join Avalere experts for Part 2 of our Market Access Enablement Strategies webinar series to learn about the policy changes and market factors that could impact the future relationships between manufacturers, health plans, and pharmacy benefit managers.
Omar Hafez Joins Avalere Health, Expands West Coast Footprint
Hafez expands Avalere's market access capabilities with deep expertise in strategy, operations, commercialization, and analytics.
Research Agenda for Health Equity Released in Collaboration with RWJF
Avalere is releasing a new research agenda to guide evidence generation for health system models of care that advance the intersection of social and clinical needs of Medicaid-eligible individuals.
Avalere Helps NYSHealth Improve Physician-Patient Cost Conversations
Avalere’s issue brief highlights real-world examples of how cost of care can be woven into physician-patient conversations and how it can improve dialogues.
Emerging Trends in Oncology Management
As treatment advancements in oncology continue, stakeholders are modifying their approaches to defining value and managing care
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.
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.
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.
Podcast: E1 – Start Your Day with Avalere: Defining Value in Oncology
In the first episode, Sam Ferguson and Biruk Bekele, consultants in Avalere’s Market Access practice, along with Milena Sullivan, a principal in Avalere’s Policy practice, will discuss how stakeholders are defining value in oncology.
Avalere Health Deepens Expertise in Market Access and Policy Analytics
Two new hires come to the firm with significant experience in US healthcare.
Webinar: Understanding Shifts from Medicare Part B to D in Autoimmune Treatment
Avalere experts examined evolving stakeholder-specific considerations for reshaping how patients with autoimmune conditions receive care during and after the COVID-19 pandemic.
Webinar: Post-Acute Care Trends to Watch in 2020 and Beyond
Avalere experts discussed the latest policy, reimbursement, and program changes affecting post-acute care and why they matter.
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.
Live Discharge Rates for Hospice Patients Vary by Diagnosis
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 Adjust to the PDPM Era
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.
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.
4 Things Hospital Executives Need to Know About Post-Acute Care
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.
4 Key Takeaways from USPSTF Recommendations for BRCA-Related Cancers & Risk-Reducing Medications
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.
Understanding ICER’s Evolving Influence on Drug Pricing and Negotiation
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.
