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.
Featured Content
Premium Content
Premium Content
Payer Trends in Oncology
The shift from volume to value has played a significant role in shaping current payer behavior in the oncology space.
What Are Association Health Plans?
On January 4, the Department of Labor (DOL) issued a proposed rule to allow certain self-employed individuals, small businesses, and large businesses, including as part of a professional/trade organization or chamber of commerce, to band together to provide health insurance for their employees and their dependents.
2018 Healthcare Industry Outlook
2018 will bring change from all parts of the healthcare system.
Our Take on the BPCI Request for Application Announcement
The Centers for Medicare & Medicaid Services (CMS) have released a Request for Application (RFA) for the Bundled Payments for Care Improvement (BPCI) Advanced Initiative.
Gillian Woollett’s Research Published in BioDrugs
Gillian Wollett, Senior Vice President of Avalere’s FDA & Regulatory Policy team, recently published “A ‘Global Reference’ Comparator for Biosimilar Development” in BioDrugs.
Final 2018 Exchange Enrollment Numbers
At 100% of the OEP, we are at 96% of total Healthcare.gov enrollment compared to 2017 (8.8M n 2018 compared to 9.2M in 2017).
FDA Prepares for the Next Generation of Regenerative Medicines
In its new regulatory framework for regenerative medicines released in November 2017, FDA takes a flexible approach, creating opportunity for manufacturers.
Issue Brief: The Promise of Shared Decision-Making in Improving Value in the US Healthcare System
Evidence suggests that shared decision-making can play a role in advancing a value-based care delivery system.
Emerging Trends for Market Access Planning in 2018
Market access teams should consider 3 growing trends in their 2018 strategic planning.
Our Take on the Final QPP Rule
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a final rule that makes changes to the second year of the Quality Payment Program (QPP) for 2018. The QPP was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Our Take on the NBPP Proposed Rule
This past Friday, the Centers for Medicare & Medicaid Services released the proposed Notice of Benefit and Payment Parameters (NBPP) for the 2019 plan year.
Impact Evaluation: Medicare Advantage Transition from RAPS to EDS
In February 2017, Avalere, an Inovalon company, analyzed data from eight Medicare Advantage Organizations (MAOs) representing 1.1 million beneficiaries in more than 30 unique plans operating across the country to understand the impact of shifting the determination of plan risk scores from the traditional Risk Adjustment Processing System (RAPS) to the new Encounter Data System (EDS).
Vaccine Coverage Requirements Vary by Market
Avalere has released a new white paper explaining the current insurance coverage requirements for vaccines and the laws that govern those requirements for the Medicare (Parts B and D), Medicaid, and commercial (group and individual) markets.
Christie Teigland Contributes to NQF’s Disparities Report
Avalere’s Teigland was selected by the National Quality Forum to participate in the Disparities Standing Committee.
Avalere’s Take on the MA/PD Landscape Files Release
The Centers for Medicare & Medicaid Services (CMS) just released the annual Landscape Files containing data on plan participation, beneficiary premiums, and benefit designs for the 2018 Part D — Medicare's prescription drug benefit — and Medicare Advantage (MA) markets.
Dan Mendelson Op-ed Featured in Medtech Insight
Avalere's President and Founder, Dan Mendelson, recently wrote a column about the new strategies that device manufacturers should take in this era of healthcare.
FDARA Builds on Progress in Expanded Access
The FDA Reauthorization Act of 2017 (FDARA), which was signed into law on August 18, 2017, calls on FDA to examine underlying barriers to access to investigational drugs.
Pharmacist Immunization Authority Associated with Higher Seasonal Influenza Immunization Rates
Avalere recently partnered with the National Association of Chain Drug Stores (NACDS) to explore the role that pharmacists can play in the uptake of seasonal influenza immunizations.
Our Take on the Senate Passage of the FDA User Fee Reauthorization Bill
Today, the Senate voted to pass H.R.2430, the FDA Reauthorization Act of 2017.
Part D Premiums Update: What You Need to Know
On July 31, the Centers for Medicare & Medicaid Services (CMS) announced that the base Part D premium will be $35 for 2018.