Insights & Analysis
There’s one constant in healthcare: change. Count on us to break down the trends so you can stay up to date. Follow our take on each piece of this deep, intertwined, and often perplexing industry to find opportunities and practical approaches to move healthcare forward.
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Global Malnutrition Composite Score Included in IPPS Proposed Rule
The proposed inclusion of the Global Malnutrition Composite Score in the Hospital Inpatient Quality Reporting Program will enable hospitals and their patients to benefit from identifying and addressing malnutrition. The measure’s use facilitates high-quality and comprehensive nutrition care that begins in the inpatient setting and continues across transitions of care.
340B Hospital Child Sites and Contract Pharmacy Demographics
Avalere analysis finds that 340B child sites and contract pharmacies are often located in less diverse and higher income ZIP codes than their disproportionate share hospital parent entities.
Health Plan Roles in Addressing Health Equity with Quality Measures
Quality regulators are implementing new requirements and performance measures to expand health equity expectations for health plans. Avalere describes common approaches and identifies data-driven strategies to respond.
Final CMS Alzheimer’s Coverage Memo Will Impact Access Beyond Medicare
The final CMS NCD for amyloid beta-targeting monoclonal antibodies for Alzheimer’s Disease establishes a dual pathway to Medicare coverage based on FDA approval and likely creates access and operational challenges for stakeholders.
Socioeconomic Factors May Impact Patient Access to Cell Therapies
Analysis finds that patients face barriers to cell therapy treatments regardless of proximity to cell therapy treatment sites.
Medicare Draft NCD for Alzheimer’s Drugs Poses Equity Questions
Avalere analysis seeks to understand potential access to clinical trial sites by race, given the draft requirement to ensure diverse participation.
Enrollment in MA Plans with SSBCI Nearly Quadrupled Since 2020
In 2022, nearly 4.5 million beneficiaries are in Medicare Advantage (MA) plans offering Special Supplemental Benefits for the Chronically Ill (SSBCI), compared to 1.2 million in 2020, the first year these benefits were available.
Microarray Patches Could Improve Pandemic Vaccination
The rollout of COVID-19 vaccines highlights the need for continued innovation in how vaccines are delivered.
Shaping Health Equity Policy in 2022
Multiple health equity focused policy proposals are expected in 2022. Healthcare organizations should be primed to engage in comment periods and evaluate readiness for changes to quality measures.
How Healthcare Staffing Shortages Are Changing the Labor Market
A nationwide shortage of clinical and non-clinical professionals is straining the healthcare industry. Every part of the health ecosystem is making contingency plans for this ongoing and worsening labor shortage. Solutions range from traditional market approaches of wages and benefits to innovative staffing activities and advocating for policy changes.
PREVENT Act Creates Opportunities for Life Sciences
The COVID-19 pandemic identified gaps in US public health infrastructure and resources, prompting policy proposals and opportunities for stakeholder engagement.
Avalere Data on Breast Cancer Screening Disparities Published in AJMC
Avalere analysis conducted in collaboration with the Community Oncology Alliance (COA) was published in the American Journal of Managed Care, showing disparities in breast cancer screening rates during the COVID-19 pandemic among racial and ethnic minority groups and based on insurance type.
3 Ways Manufacturers Can Prepare for New 2023 Discarded Drug Rebate
As manufacturers prepare for discarded drug rebates to begin in 2023, an Avalere analysis identified 39 drugs at risk for rebates totaling $151 million.
Cancer Moonshot Highlights Opportunities to Improve Cancer Care
On February 2, 2022, President Biden announced a revitalization of the Obama-era Cancer Moonshot Initiative, including updated goals to reduce cancer deaths by at least 50% over the next 25 years and improve the experience of cancer survivorship for patients and their families.
Medicare Draft Coverage for Alzheimer’s Drugs May Challenge Access
Thirty-one percent of rural Medicare fee-for-service beneficiaries with early-onset Alzheimer’s disease or a mild cognitive impairment diagnosis do not have access to a hospital outpatient department in their county, and fewer than 1% live near an Alzheimer’s disease research center.
Advancing the Use of Digital Health Technologies
The digital health technologies (DHTs) market is projected to grow from $3.5 billion in 2020 to $23.5 billion by 2030. Stakeholders must navigate complex pathways as the FDA develops regulatory frameworks for DHTs.
Patient Preferences in Triple Negative Breast Cancer Treatments
To determine the attributes of triple-negative breast cancer treatment that play a direct role in patient treatment decision making at treatment initiation and following initial treatment selection, Avalere conducted focus groups to examine treatment experiences of patients with triple-negative breast cancer and elicit their treatment-related preferences.
Medication Adherence Disparities Linked to Race, Socioeconomic Factors
An Avalere analysis finds that a smaller share of Black and Hispanic Medicare beneficiaries and beneficiaries in lower socioeconomic quartiles have sufficient adherence for commonly used medications. The analysis also shows greater disparities in Medicare plans rated 3 stars or fewer.
Looming Deadlines Could Trigger Congressional Action on Healthcare
Congressional Democrats have indicated interest in a slimmed-down BBBA alternative that could pass the Senate. Pending deadlines and the expiration of ARPA subsidies may create impetus for Democrats to act on legislative health care priorities in 2022.
Midlife Prevention of Alzheimer’s Disease
Although Alzheimer’s disease has no known cure, recent evidence points to several advancements that may enhance the understanding of the progression of the disease.