Meet
Mark Newsom

Managing Director

Mark Newsom provides policy analysis and strategic advice to stakeholders across the healthcare continuum, with a focus on government health programs.

Before joining Avalere, Mark recently served as deputy director of the Medicare Drug Benefit and C&D Data Group (MDBG) at the Centers for Medicare & Medicaid Services (CMS). MDBG drives Medicare Part D benefit policy and formulary reviews, the Stars quality program for both Medicare Advantage (MA) and Part D and the Medication Therapy Management program. Previously, Mark led the Division of Payment Reconciliation in the Medicare Plan Payment Group focusing on implementation of the invoicing for the coverage gap discount program and collection of Part D prescription drug event data and direct and indirect remuneration reports.

Mark has also served as an analyst and advisor both at CMS and the Congressional Research Service focusing on key plan policy issues including risk adjustment, prior authorization and coverage of physician administered (Part B) drugs. In industry, he served as vice president of public policy at Humana, leading development and implementation of federal policy strategy, serving as a co-executive sponsor of Humana’s real world evidence research and working on the Kindred at Home acquisition. Mark also served as director and executive advisor of public policy at CVS Health where he focused on Medicare, Medicaid, and Marketplace policy impacting the pharmacy benefit manager and prescription drug plan businesses. He has provided policy due diligence analysis for the Coram and Omnicare acquisitions and has served as a director of Medicare compliance at Coventry.

Mark holds an MS in health policy and administration from the University of Illinois and completed the business of healthcare graduate program at the Carey Business School of Johns Hopkins University.

Authored Content


Healthcare stakeholders are increasingly using AI in front- and back-office applications, but few tools have been able to achieve expected results once organizations deploy them at-scale.

CMS’s post-IRA updates to the RxHCC risk adjustment model have varying effects on plan loss ratios across therapeutic areas.

In the CY 2027 Medicare Advantage policymaking cycle, the Trump administration is expected to propose changes to payments, oversight, and Star Ratings.

Avalere Health examines how new federal and state efforts to oversee PBM-pharmacy ownership may affect stakeholders systemwide.

State oversight of AI in healthcare has primarily focused on prior authorization, disclosure and operations requirements, and scope of practice.

Continued NAMBA increases and changes to the Part D Premium Stabilization Demonstration may signal further destabilization of the standalone PDP market.

Avalere Health Advisory experts break down major updates to the CMS Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) audit process, including enhanced technology, workforce expansion, and increased audit volume, and how health plans can prepare.

A new EO revives international reference pricing as a core Trump administration priority, with a focus on Most-Favored Nation pricing through direct-to-consumer models, regulatory action, and broader enforcement measures.