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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Follow the Pill: Understanding the Prescription Drug Supply Chain
Prescription drugs are dispensed to patients through a complex supply chain that involves a broad array of entities, contract arrangements, and payments. The following diagram outlines how a typical prescription drug may flow through the drug supply chain.
Provider Impact of COVID-19 Recession and Coverage Trends
A potential recession due to job losses and business closings as a result of COVID-19 will cause shifts in the payer mix and, ultimately, revenue dynamics for physician practices.
Updated National Malnutrition Blueprint Advances Integrated Solutions
Citing alarming statistics that nearly 1 of every 2 older Americans is at risk of malnutrition and that disease-associated malnutrition in older adults is estimated to cost nearly $53 billion annually, a broad group of advocates has presented a updated roadmap for a continuing national effort to help millions of Americans who suffer from malnutrition or could be at risk as they age. The expected rising incidence of malnutrition amidst the current COVID-19 pandemic makes it even more critical to advance solutions across all points of care.
COVID-19 Outbreak Exacerbates Impacts of Social Determinants of Health
The COVID-19 pandemic has revealed several weaknesses in our country’s web of safety net programs. Although the virus may not discriminate, it may exacerbate existing health inequities driven by social determinants of health (SDOH).
Post-COVID-19 Considerations for the Commercial Health Coverage Market
Faced with a rapidly evolving healthcare environment, there are a number of important uncertainties that commercial insurers will need to consider when planning for the future
COVID-19 Relief Funding for Healthcare Providers
Avalere analysis of the distribution of provider relief funds indicates geographical concentration related to the number of reported COVID-19 cases.
Opportunities to Modernize the Vaccine Injury Compensation Program
A proposal to eliminate shoulder injuries from the list of vaccine-related conditions that warrant federal compensation through the National Vaccine Injury Compensation Program (VICP) highlights the administrative challenges posed by these claims and provides an opportunity to consider reforms to modernize the program.
10 Drivers Complicate the Medicaid Outlook Amid the COVID-19 Pandemic
State Medicaid programs face a series of near- and long-term challenges amid the COVID-19 pandemic due to enrollment growth and financial pressures. Stakeholders should evaluate key drivers shaping the state-by-state Medicaid outlook.
COVID-19 Will Impact Provider Performance Reporting and Value-Based Care
The impact of COVID-19 goes beyond the disease and produces additional strain on the healthcare system, including managing patients and meeting cost and quality drivers.
COVID-19 is Stressing a Fractured Mental Healthcare System in the US
Mental Health Awareness Month and the COVID-19 crisis intersect—and highlight challenges in the US mental health care system
After the Rollover from Drugs to Biologics: What Remains Uncertain?
The Biologics Price Competition and Innovation Act (BPCIA) mandates that specific protein products that were approved as drugs under section 505 of the Federal Food, Drug, and Cosmetic Act (FD&C Act) be licensed as biologics under section 351 of the Public Health Services Act (PHS Act) as of March 23, 2020.
The Burden and Costs of Recurrent Clostridioides Difficile
Recurring episodes of clostridioides difficile (c diff) create significant added healthcare burden and costs to society and lead to avoidable adverse outcomes in the Medicare population
Emergency State Licensing Flexibilities May Improve Provider Access
Recent regulatory changes have eased restrictions for providers delivering care across state lines during the COVID-19 public health emergency. However, state and federal cooperation on extended licensure expansion would help address long-term provider access issues.
Insights from the Influenza Vaccine Market for COVID-19 Vaccines
The evolution of the US influenza vaccine market offers insights into the potential barriers and opportunities for successful rollouts of novel COVID-19 vaccines.
What’s Next for Medicaid Drug Pricing?
On February 27, Avalere experts discussed the latest policy, pricing, and reimbursement challenges for prescription drugs in Medicaid in the “What’s Next for Medicaid Drug Pricing?” webinar. They reviewed the ways prescription drugs are managed in Medicaid, what innovative medicines may mean for the program, and potential implications of CMS’ Healthy Adult Opportunity (HAO).
What’s Next for Telehealth? HITECH May Offer Lessons
Major catastrophes, like natural disasters, global pandemics, and sudden economic downturns require rapid interventions to protect the American public from long-term health and financial damage. Because there is significant momentum and political will during and immediately following a catastrophe, promising innovations may be fast-tracked.
COVID-19 and Its Impact on the Global Drug Supply Chain
Although COVID-19 is introducing new challenges within the global pharmaceutical supply chain, the current situation also creates opportunities for stakeholders to evaluate drug security and implement risk-mitigation strategies around shortages and required stockpiles.
The Impact of COVID-19 on the Health Insurance Industry
On April 9, Avalere experts came together to discuss the impact of COVID-19 on the health insurance industry.
Patients with Undermanaged RA Have Higher Medicare Costs than Other RA Patients
Avalere analysis finds that Medicare fee-for-service (FFS) patients with an RA diagnosis and conditions associated with undermanaged disease have 121% higher medical costs than other RA patients. Part D costs were 30% higher for those with undermanaged disease than for other RA patients.
COVID-19 Poses New Challenges in the Evolving Kidney Care Landscape
The kidney care payment and delivery landscape was poised for change in 2020 due to existing policies and market trends. Given the specific risk COVID-19 poses to these patients, the pandemic is creating new challenges and potentially accelerating existing trends in the kidney care space.