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
Actionable Resources to Facilitate Cost Conversations Between Patients and Clinicians
As part of the Robert Wood Johnson Foundation Cost Conversation projects, Avalere led the development of a set of practice briefs that provide actionable resources to healthcare providers about how to improve the value and frequency of cost conversations with patients.
Multidisciplinary Workgroup Publishes Appropriate Use Criteria for LP and CSF Testing for the Diagnosis of Alzheimer’s Disease
Today, Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association published appropriate use criteria (AUC) to guide the use of lumbar puncture (LP) and cerebrospinal fluid (CSF) analysis for use in the diagnosis of Alzheimer’s disease.
Podcast: E3 – New Appropriate Use Criteria Increases Likelihood of Accurate Diagnosis for Alzheimer’s Disease
Tune in to our podcast series where guest presenters explore the value of the newly released Alzheimer’s Association appropriate use criteria for lumbar puncture and cerebral spinal fluid (CFS) testing in the diagnosis of Alzheimer’s disease. Dr. Steven Salloway, Director of Neurology and the Memory and Aging Program at Butler Hospital, discusses how the Alzheimer’s Association’s new appropriate use criteria for lumbar puncture and cerebrospinal fluid testing in the diagnosis of Alzheimer’s disease will be helpful to clinicians in the diagnostic process.
Podcast: E2 – CSF Clinical Diagnosis’ Used to Inform Guidance on Detecting Alzheimer’s Disease
Tune into the second podcast in our series where Dr. Leslie Shaw, Professor of Pathology and Laboratory Medicine at the Pearlman School of Medicine at the University of Pennsylvania and Chair of the Workgroup that developed the Alzheimer’s Association’s appropriate use criteria for lumbar puncture and cerebral spinal fluid (CSF) testing in the diagnosis of Alzheimer’s disease, discusses how the Workgroup reviewed an extensive body of research on advances in CSF testing to develop the AUC.
Podcast: E1 – New Appropriate Use Criteria in Diagnosing Alzheimer’s Disease
Tune in to our podcast series as we explore the value of the newly released Alzheimer’s Association appropriate use criteria for lumbar puncture and cerebral spinal fluid (CFS) testing in the diagnosis of Alzheimer’s disease. We kick off this series with Dr. Maria Carillo, the Alzheimer Association’s Chief Science Officer and Dr. Jim Hendrix, Director of Global Science Initiatives.
Provider Performance Under Oncology Care Model Varies by Cancer Type
Clinicians who treat certain types of cancer may be better positioned to earn performance-based payments under the Oncology Care Model.
Health Plan Interest in Outcomes-Based Contracts Increasing
Outcomes-based contracts most common in cardiovascular disease, infectious disease, and oncology.
Strategic Imperatives for Skilled Nursing Facilities Preparing for New Payment System
In August 2018, CMS is expected to finalize a proposed new payment methodology for skilled nursing facilities (SNFs) that would shift the focus from resource use to patients’ clinical needs.
More than 1 in 5 Medicare Cancer Patients Receive Care from Oncology Care Model Doctors
More than 25% of patients with breast and lung cancers have been treated by a participating Oncology Care Model doctor. Participation trends could accelerate the transformation of treatment for some cancers, according to Avalere experts.
CMS Takes Steps to Advance the “Meaningful Measures” Initiative
CMS removes 25 existing hospital quality measures in the Proposed FY2019 Inpatient Prospective Payment System (IPPS) Rule as part of its broader effort to focus on measures that matter.
Financial Results of MSSP and CMMI Demos Are Mixed
MSSP and CMMI demonstrations vary in budgetary impact but generally show quality improvement.
Registries Continue to Give More Opportunities for Clinicians to Meet Reporting Requirements
The number of CMS-approved Qualified Clinical Data Registries grew by 40% in 2018, allowing specialties to have more opportunities to report on meaningful quality measures.
Medicare ACOs Have Increased Federal Spending Contrary to Projections That They Would Produce Net Savings
Incentive payments in upside-only Medicare ACOs have increased federal costs, but data suggest that ACO experience and adoption of two-sided risk could constrain future Medicare costs.
Medicare Financial Incentives Encourage Providers to Take on Greater Financial Risk
While clinicians have been hesitant to assume risk, bonus payments would result in 9 out of 10 ACOs and their participants achieving a net positive financial impact.
Emerging Trends for Market Access Planning in 2018
Market access teams should consider 3 growing trends in their 2018 strategic planning.
Webinar: The Data-Driven Enterprise: Drive Growth and Deliver Value
Learn more how analytics derived from proprietary commercial datasets empower provider executives to successfully partner across the healthcare industry.
Our Take on the Final QPP Rule
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes to the second year of the Quality Payment Program (QPP) for 2018. The QPP was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Podcast: E4 – Digital Health the Missing Partner in Pain Management?
In the final episode of our digital health podcast series, we interview Martha Lawrence, Chief Executive Officer of AccendoWave, discussing how technology has the promise to reduce pain for patients as an alternative to opioids. AccendoWave's system assesses patient discomfort levels using EEG technology.
Podcast: Evolving Value-Based Care Strategies in 2017 and Beyond
Tune in as Avalere's Fred Bentley explores how a leading health system adapts to evolving value-based payment models in an interview with Dr. Robert Nesse, senior director for Payment Reform at Mayo Clinic.
CMS Proposal for New Medicare Payment System Could Lead to Large Payment Variability for Specialists
New analysis from Avalere finds that payments to certain physician specialists could increase or decrease by as much as 16% for their 2018 performance under the Merit-based Incentive Payment System (MIPS).