
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.

Physician-Led Accountable Care Organizations Outperform Hospital-Led Counterparts
Medicare ACOs continue to realize experience-level results.

Avalere’s Home Health Expertise Featured in AHHQI Chartbook
For the last several years, Avalere has worked with the Alliance for Home Health Quality and Innovation (AHHQI) to analyze the ever-changing home health landscape.
More than Half of Health Plans Use Outcomes-Based Contracts
Cost savings and improved clinical outcomes cited as top advantages for payers according to survey conducted by Avalere Health.
Interview: E3 – Avalere Insights on Recent CMS Proposed Payment Rules: ESRD PPS and Quality Incentive Program
Tune in to hear the final episode in our 3-part series that focuses on CMS’s most recent proposed payment rules. In episode 3, we’ll be focusing on the End Stage Renal Disease (ESRD) Prospective Payment System, with a focus on proposed payment changes for innovative drugs, supplies, and equipment and updates to the Quality Incentive Program (QIP).
Maximizing Access in an Evolving Policy and Payer Landscape
Manufacturers currently face an almost-unprecedented level of uncertainty in developing contracting strategies for the coming plan years. Avalere’s combination of policy and commercialization expertise, paired with its data capabilities, allow us to support life sciences companies understand this challenging landscape to ensure access to innovative therapies for their patients.
Avalere and the Robert Wood Johnson Foundation Launch Initiative to Transform Health Systems
Avalere will serve as the RWJF Health Systems Transformation Research Coordinating Center to meet patients’ interrelated clinical and social needs.

Getting Ready for Primary Care First: Ambitious CMMI Initiative Aims to Redefine Primary Care
Announced in late April, the Center for Medicare & Medicaid Services’ (CMS) Primary Care First initiative marks a critical step forward in the long and complex journey toward a fundamentally transformed healthcare system.
Ensuring Appropriate Access to Pulmonary Arterial Hypertension Therapy
Avalere experts published a supplement in the June 2019 American Journal of Managed Care entitled “Ensuring Appropriate Access to Pulmonary Arterial Hypertension Therapy.”
Avalere Adds New Experts in Payer, Pharmacy Benefit Management, Provider and Specialty Markets
Dr. Roy Beveridge and Mike Schneider Join the Firm
Avalere Participates in Initiative to Advance the Identification and Management of Heart Valve Disease
In January 2018, Avalere Health partnered with the Society of Cardiovascular and Angiography Interventions to launch the development of the Heart Valve Initiative.
Avalere and Other Scientific Leaders Publish Paper on Advances in Value Frameworks
Paper details recent developments in leading value frameworks, including Avalere’s Focus on Patient Orientation in Value Assessment.
Cancer Treatment Costs Are Higher Among Oncology Care Model Participants than Benchmarks Predict
A new Avalere analysis finds that oncology practices participating in the Oncology Care Model (OCM) treated patients with 2–3% higher Medicare costs per episode, on average, than OCM prediction model estimates during the first two performance periods.
Avalere Deepens Expertise in Medicare and Clinical Decision-Making with 2 New Hires
Matt Kazan and Amy Schroeder bring unique understandings of how policy and clinical data drive healthcare markets.
More than Half of All OCM Providers Could Owe CMS Money if Required to Join in 2-Sided Risk Model
Pressure to lower costs will increase for OCM providers as CMS pushes to 2-sided risk.
Webinar: A Conversation on Oncology: Download the Slides and Listen to the Recording
Ahead of the American Society of Clinical Oncology's annual meeting, Avalere experts discussed the latest trends in policy, reimbursement, and market access reshaping oncology care.
Avalere Partners with Leading Health Care Foundation, Provider Associations, and Advocacy Groups to Improve Conversations About Costs Between Patients and Clinicians
A supplement to Annals was just published that includes research on how to help physicians talk with their patients about costs of care, including a commentary co-authored with Avalere.

What Will Drive SNF Profitability Under the New Patient-Driven Payment Model?
Liz Moore recently sat down with Fred Bentley, managing director, to talk about the Patient-Driven Payment Model (PDPM) and how it may impact skilled nursing facility (SNF) profitability. Check out the interview below.
Enhancing Manufacturer Partnerships in an Evolving Specialty Landscape
Recent developments in the specialty pharmaceutical marketplace merit distinct attention from manufacturers.

CMS Announces 5 New Advanced Primary Care Payment Models
The CMS announced the new CMS Primary Cares Initiative, comprising 5 new payment models under 2 programs, which will test the impact of providing considerable financial incentives and flexibility to primary care practices and organizations in exchange for significant provider risk.
Bringing Real Innovation to Medicare
The Centers for Medicare & Medicaid Services (CMS) is currently reviewing a new payment rule, which could impact coverage of innovative procedures like transcatheter aortic valve replacement for the treatment of severe aortic stenosis.