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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Readmission Rates Are 6 Times Higher for Some Conditions in Medicare’s New Bundled Payment Program
As the deadline approaches for providers to make decisions on their participation in BPCI Advanced, Avalere analysis shows that certain conditions may provide greater opportunity for success.
Trump Administration Releases Drug Pricing Blueprint
The Department of Health and Human Services is seeking public input on a variety of proposals related to drug costs, providing stakeholders with an unprecedented opportunity to shape the administration's drug pricing policies.
CMS Takes Steps to Advance the “Meaningful Measures” Initiative
CMS removes 25 existing hospital quality measures in the Proposed FY2019 Inpatient Prospective Payment System (IPPS) Rule as part of its broader effort to focus on measures that matter.
State-Level Policies Can Play Key Role in Improving Adult Immunization Rates
States can pursue various policy opportunities to encourage vaccination and increase access to vaccines.
The Medicare Advantage Factor in Assisted and Senior Living Facilities
Avalere's founder and president, Dan Mendelson, recently sat down with Senior Housing News editors to discuss opportunities for senior living providers to leverage data to facilitate synergistic partnerships with payers.
Use of Step Through Policies for Competitive Biologics Among Commercial US Insurers
Avalere evaluated payer policies for biologics when biosimilars are available.
Emerging Opportunities to Drive Adult Immunization Through Quality
Quality measurement in the adult vaccine space has evolved rapidly. Recent advancements continue to propel efforts to drive adult immunization uptake.
The Future of the Center for Medicare & Medicaid Innovation
On April 24, 2018, Avalere experts were joined by Aledade CEO, Farzad Mostashari, MD, to discuss the latest developments coming out of the Center for Medicare & Medicaid Innovation (CMMI).
The Opioid Crisis: An Ongoing Legislative Priority
The House and Senate are advancing legislative packages aimed at mitigating the crisis.
Recent Proposals by the Administration Hint at Areas of Focus for Upcoming Drug Pricing Plan
President Trump is expected to announce a drug pricing plan in the coming weeks; signals from the White House indicate potential alignment around several priority policies.
Patient Out-of-Pocket Assistance in Medicare Part D: Direct and Indirect Healthcare Savings
Avalere examines the effect of foundation-sponsored financial assistance on out-of-pocket costs and federal spending.
Financial Results of MSSP and CMMI Demos Are Mixed
MSSP and CMMI demonstrations vary in budgetary impact but generally show quality improvement.
Policymakers Seek to Balance Patient Information Sharing with Privacy Protections
Coordinated information sharing can facilitate the delivery of integrated care to patients using both physical and behavioral health services.
Limits on Opioid Prescriptions Are Becoming More Widespread
In response to the concern that overprescribing is a driver of the opioid crisis, payers are limiting opioid fills as one solution.
CMS Gives More Flexibility to States When Regulating Health Insurance
The Centers for Medicare & Medicaid Services released the final Notice of Benefit and Payment Parameters (NBPP) for the 2019 plan year.
Two-Year Countdown Begins for FDA “Roll-Over” of Biologics Currently Regulated as Drugs
In just two years, on March 23, 2020, biologics currently regulated as drugs will transition to being regulated as biologics. Many aspects of how FDA will implement this transition have yet to be established.
Issue Brief: The Elements of a Competitive Biologics Market
Most people are familiar with generic drugs as less costly alternatives to drugs whose patents have expired.
The Seven Types of Drug Pricing Legislation to Watch
Increasingly, states are taking steps to control prescription drug spending and prices.
Adapting to Medicaid Changes and Trends in 2018
On March 6, Avalere experts came together to discuss the latest Medicaid developments.
The Endocrine Society and Avalere Experts Publish Findings on Hypoglycemia Prevention in Type 2 Diabetes Patients
The findings, published in The Journal of Endocrinology & Metabolism, will guide a pilot study to assess interventions to improve the identification and management of diabetes patients at high risk for hypoglycemia.