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.

Interview: 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.

Interview: 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.

Interview: 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.

Interview: E9 – Get the Facts on COVID-19: Alternative Payment Model Impacts

Tune into the ninth episode of our podcast series, Get the Facts on COVID-19. In episode 9, Avalere experts from the Health Plans and Providers practice and the Center for Healthcare Transformation discuss the near- and long-term impacts of COVID-19 on value-based contracting and Alternative Payment Models (APMs). The conversation focuses on Medicare programs, such as specialty Accountable Care Organizations (ACOs) and bundled payment models, and newer Center for Medicare and Medicaid Innovation (CMMI) programs.

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.

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.

MSSP Sees Continued Growth in Downside Risk ACOs

New analysis from Avalere finds that more accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) have assumed downside risk as the program matures, with the greatest growth over the past 3 years.

Fred Bently

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.

Fred Bently

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.

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.

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