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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4 Compelling Use Cases for Blockchain in Healthcare
While emerging blockchain technology is expected to impact a range of businesses in the years ahead, its strengths seem particularly well suited for the complex data-sharing demands of the pharmaceutical and healthcare industries.
7 State Policy Trends that May Shape Cancer Care in 2020
State healthcare legislation often holds important implications for high-value and high-cost drugs, such as those used to treat cancer patients.
Takeaways from NASHP: What’s Next in the States in 2020
Avalere’s state policy team recently attended the National Academy for State Health Policy’s (NASHP) Annual Conference for 3 days of interactive state health policy discussions and the facilitation of a roundtable on the direction of telehealth in the states.
New Innovations in Healthcare Aim to Address Social Determinants of Health
A wide variety of health plans, provider networks, and national corporations have recently developed and announced innovations and strategies to expand access to healthcare and to address needs that promote health across communities.
CMMI Program Savings Fall Below CBO’s 2016 Projections
CMMI’s impact on Medicare spending has so far not reached earlier projections by the Congressional Budget Office, demonstrating the difficulty in projecting savings from new and unknown alternative payment models.
Avalere Experts Discuss 2020 Regulatory Changes to the Insulin Market
On August 6, Avalere’s regulatory experts published an article in BioDrugs highlighting upcoming regulatory changes for insulin.
Maximizing Access in an Evolving Policy and Payer Landscape
Manufacturers currently face an almost-unprecedented level of uncertainty in developing contracting strategies for the coming plan years. Avalere’s combination of policy and commercialization expertise, paired with its data capabilities, allow us to support life sciences companies understand this challenging landscape to ensure access to innovative therapies for their patients.
3.7M Part D Beneficiaries Are Projected to Reach the Catastrophic Phase in 2020
As policymakers consider reforms to Part D, new Avalere analysis shows that congressional proposals to cap out-of-pocket (OOP) costs in the catastrophic phase are likely to reduce OOP for many beneficiaries
Avalere’s Malnutrition Initiative Featured in the Journal of the Academy of Nutrition and Dietetics
Avalere’s efforts to advance the national Malnutrition Quality Improvement Initiative featured in newly published supplement of the Journal of the Academy of Nutrition and Dietetics.
States Explore Increasing Access to Telehealth as New Opportunity for Quality Care
States are increasingly seeking to improve access and health outcomes for their underserved, rural, or homebound populations, and many are turning to telehealth as a solution.
Impact of Proposed CMS Methodology for Calculating Payment Errors May Vary Based on Plan Enrollee Characteristics
In 2018, CMS proposed to revise its Risk Adjustment Data Validation (RADV) methodology to exclude the FFS Adjuster in its payment recoupment calculations. New analysis from Avalere finds that the payment impact associated with fee-for-service (FFS) Medicare coding discrepancies would be greater for certain subgroups of beneficiaries (e.g., dual-eligible, those with certain common and potentially serious health conditions) enrolled in the MA program.
The Evolving Newborn Screening Landscape
On August 21, Avalere policy experts published a piece on the Health Affairs blog highlighting the impact of advancements in treatment and screening technology on the newborn screening landscape.
The VA National Formulary for Top Medical Benefit Drugs Is Narrower than Current Medicare Part B Drug Coverage
Avalere analysis finds that 24 of the top 50 non-vaccine Part B drugs are not on the U.S. Department of Veterans Affairs’ National Formulary.
Avalere Partners with Industry Leaders to Address Hypoglycemia in Older Adults
Avalere collaborates with the Endocrine Society and Pottstown Medical Specialists to launch a quality improvement intervention study aimed at addressing care gaps in the identification and management of hypoglycemia in older adults with type 2 diabetes.
Digital Health Guidelines Seek Evidence for Innovative Solutions
It is no surprise that innovation in the world of digital health is transforming the way healthcare is delivered.
States Taking Action to Ensure Coverage Protection Should the ACA Be Overturned
While the majority of state legislative sessions have adjourned for 2019, at least 11 states (CT, FL, LA, IN, MD, ME, NH, NM, NV, VT, and WA) have enacted laws to create or study coverage protections against pre-existing condition exclusions and coverage of all essential health benefits (EHB) provided for in the Affordable Care Act (ACA).
1 in 5 Medicare Beneficiaries Taking a Part D Cancer Therapy Reached Catastrophic Level in 2017
Avalere analysis finds that a larger proportion of beneficiaries taking a Part D cancer therapy reached catastrophic compared to all Part D enrollees.
Getting Ready for Primary Care First: Ambitious CMMI Initiative Aims to Redefine Primary Care
Announced in late April, the Center for Medicare & Medicaid Services’ (CMS) Primary Care First initiative marks a critical step forward in the long and complex journey toward a fundamentally transformed healthcare system.
Methodology and Analysis of the Center for American Progress’s Medicare Extra Policy Proposal
The Center for American Progress (CAP) commissioned Avalere to evaluate ‘Medicare Extra’ as a package of reform polices implemented and phased in over time across the US healthcare system.
Quality Summit Provides Industry Opportunity to Shape Quality Programs
On July 9, Health & Human Services (HHS) announced the formation of the Quality Summit (QS), as directed by a recent executive order aimed at improving price and quality transparency.