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.
Medicare FFS Utilization Decreased During the COVID-19 Pandemic
Avalere analysis finds healthcare utilization among Medicare Fee-for-Service (FFS) beneficiaries decreased in the spring of 2020 compared to the spring of 2019.
Senior Preferences for COVID-19 Vaccination Released with Tivity Health
The COVID-19 pandemic has disproportionately impacted seniors nationwide, with this population at an increased risk of hospitalization or death following a COVID-19 diagnosis.
Impacts of Part D Redesign Vary by Therapeutic Area
New Avalere analysis finds that 3 proposals to redesign the Part D benefit—H.R.19/S.3129, Prescription Drug Price Reduction Act (PDPRA), and Elijah Cummings Lower Drug Costs Now Act (H.R.3)—would increase 2023 mandatory manufacturer discounts by 80%, 81%, and 283%, respectively, with significant variation across therapeutic areas.
MA Enrollment in Plans with Extra Benefits for Chronically Ill Tripled in 2021
Over 3 million Medicare Advantage (MA) beneficiaries are enrolled in plans providing additional supplemental benefits to individuals with chronic illnesses, compared to just over 1 million in 2020.
Considerations in Ensuring Equitable COVID-19 Vaccine Administration
On January 21, the Biden administration released its National Strategy for the COVID-19 Response and Pandemic Preparedness. The plan highlights numerous actions that the administration intends to implement as it assumes responsibility in the fight against COVID-19.
What to Watch for in MA and Part D Contracting for the 2022 Plan Year
Recent regulatory action released in the final days of the Trump administration related to Medicare Advantage (MA) and Part D could significantly impact plan and manufacturer calendar year (CY) 2022 contracting strategies and stakeholder advocacy priorities.
How COVID-19 Has Impacted US Adolescent and Adult Vaccine Utilization
Globally and in the US, widespread vaccination has demonstrated medical, economic, and social value to both individuals and public health and has contributed to reductions in morbidity and mortality of certain diseases.
A Roadmap for Advancing Care for Sickle Cell Disease
Avalere Health and Sick Cells have published a strategic roadmap, intended to advance care for individuals with sickle cell disease (SCD). The roadmap includes consensus-based solutions that various healthcare stakeholders can implement in the near future.
Considerations for Employers in the Era of the COVID-19 Vaccine
On December 14, 2020, an intensive care unit nurse in New York was the first American to receive an injection of the COVID-19 vaccine.
New COVID-19 Treatment Add-On Increases Payment Relative to NTAP
Avalere analysis finds hospitals would receive higher additional payments from Medicare through the New COVID-19 Treatment Add-on Payment (NCTAP) compared to the New Technology Add-on Payment (NTAP).
MFN Model Would Have Had a Major Impact on Certain Providers
New Avalere analysis finds that the the Most Favored Nation (MFN) Model would have a significant negative impact on Medicare providers that furnish Part B drugs—especially in oncology and rheumatology—and those in rural areas.
IoT: Opportunities and Use Cases for Life Sciences Organizations
Internet of Things (IoT) is a catch-all term that refers to any device that can connect to a network (including the Internet) and communicate with other devices.
Clearing the Path: Through the Pandemic and Beyond
Healthcare stakeholders face a unique set of challenges and opportunities in 2021 as we continue to respond to the COVID-19 pandemic and prepare for the political changes inherent in a new presidential administration. As we take stock of the historic events of 2020, it is important to look ahead toward the new era already coming into view.
10 Key Healthcare Implications of the GA Senate Runoff Elections
The outcome of Georgia’s runoff election—resulting in a Democratic majority in the Senate—combined with the existing Democratic majority in the House and incoming Biden administration, significantly changes the policy outlook for 2021.
Reducing Maternal Mortality Among Women of Color
Women of color are disproportionately affected by pregnancy-related death in the US, which has a higher maternal mortality rate than 10 other developed nations worldwide.
Investing in Health Disparities: A Framework for Accelerating Action
In response to the COVID-19 public health emergency and recent social events highlighting systemic inequities, life sciences companies have issued bold statements reaffirming their commitment to diversity, inclusion, and health equity.
Opportunities for Advancing Health Justice in the COVID-19 Era
The COVID-19 pandemic has disproportionately impacted communities of color since the first cases were identified in the United States.
Avalere and RWJF Select Grantees to Advance Health Equity
Grantees will evaluate models for transforming health systems to promote health equity for Medicaid populations.
Strengthening Patient Access for Type 2 Diabetes Preventive Services
Type 2 diabetes (T2D) rates have grown substantially over the years and have placed a significant burden on the US healthcare system. While prevention efforts continue to advance, including the availability of screening tools and early prevention therapies, systemic disparities still preclude equitable access to preventive services. These will need to be addressed as a key component of strengthening patient access to preventive care and lowering the incidence of disease.
Medicare Covers More Part B Therapies for Breast Cancer than NHS England
Avalere analysis found that in 2017 and 2018, more than half (56%) of Medicare patients with breast cancer taking a medicine covered by Medicare Part B received a therapy that was not routinely covered by England’s National Health Service (NHS) or its Cancer Drug Fund (CDF).

