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.
As treatment advancements in oncology continue, stakeholders are modifying their approaches to defining value and managing care
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.
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.
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.
The impact of COVID-19 goes beyond the disease and produces additional strain on the healthcare system, including managing patients and meeting cost and quality drivers.
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.
Two new hires come to the firm with significant experience in US healthcare.
Avalere experts examined evolving stakeholder-specific considerations for reshaping how patients with autoimmune conditions receive care during and after the COVID-19 pandemic.
In the fourth episode of this series, Avalere experts discuss the impact of the COVID-19 pandemic on care delivery and the future of telehealth.
Avalere experts discussed the latest policy, reimbursement, and program changes affecting post-acute care and why they matter.
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.
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.
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.
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.
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.
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.
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.
New analysis from Avalere finds the proposed case-mix adjustment for the radiation oncology model underestimates payments for prostate cancer .
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.
Medicare ACOs continue to realize experience-level results.