Ex-US HTAs often select different therapeutic alternatives when assessing the effectiveness of the same therapies, highlighting the complex factors that influence such decisions.
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.
Step therapy is a form of utilization management increasingly used by health plans, including Medicare Advantage plans, with the stated intent to guide prescribing decisions toward cost-effective, evidence-based therapies.
As new Alzheimer’s drugs are developed, increased plan liability pressures may shape future Part D plan management strategies
Avalere Health Advisory experts explore how the Trump Administration approached Medicare Advantage and Medicare Part D policies proposed by the Biden Administration, ranging from anti-obesity medication coverage to plan payment increases
Avalere experts discuss the CMS Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) audit process and provide insight on how health plans can proactively plan and prepare for these audits.
In the third and final installment of our AI for health plans video series, Avalere is joined by experts Mia Bolton and Teddy Gedamu from Tenasol to share real-world examples of how artificial intelligence (AI) can streamline data management and improve decision-making in health plans.
A white paper explores ways in which VBC payment models can benefit from incorporating allied health domains, such as Orthotics and Prosthetics.
In the second installment of our AI for health plans video series, Avalere is joined by experts Mia Bolton and Teddy Gedamu from Tenasol to discuss how plans are operationalizing enterprise clinical data.
Join Avalere to learn about the new Medicare Prescription Payment Plan and what it means for Part D enrollees in 2025.
In the first installment of our AI for health plans video series, Avalere is joined by experts Mia Bolton and Teddy Gedamu from Tenasol to discuss the regulatory and market dynamics around clinical data and what this means for health plans.
Join Avalere experts to learn about the changes to Part D formularies for 2025 and implications for patient access.
Avalere experts will examine changes in Part D plan options and premiums for 2025 and will explore how these shifts may affect patient costs and choice.
Join our webinar to learn how Part D redesign and drug price negotiation will shape the Plan Year 2026 market, and what this means for manufacturers and plans.
Ahead of the American Society of Nephrology Kidney Week, Avalere experts dive into the key regulatory and legislative developments related to kidney disease that expect to see action in the remaining weeks of 2024.
A new Avalere analysis reaffirms 2021 findings that first identified variability in Medicaid physician office and pharmacy vaccine reimbursement policies.
Join Avalere for an overview of how the Medicare Part D benefit will be changing in 2025 under the Inflation Reduction Act.
The number of PDP and MA-PD options are declining by 26% and 7%, respectively, in 2025.
Join us for a webinar exploring the RNA-Based Therapy landscape.
Avalere finds that between 0.1% and 0.2% of Medicare FFS beneficiaries would experience lower OOP costs for the Part B drugs subject to Q3 2024 inflation rebates.
