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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Takeaways from the Updated Better Care Reconciliation Act (BCRA)
As the Senate prepares to begin debate on a revised version of the Better Care Reconciliation Act (BCRA) next week, Avalere offers the following observations on select components of the legislation:
Elizabeth Carpenter to Present at NGA Summer Meeting
Elizabeth Carpenter, Senior Vice President, will present on July 15 at the National Governors Association Summer Meeting in Providence, RI, in a governors-only session entitled “The Future of Health Care.”
Update on The Medicare Trustee’s Report: IPAB Is Not Triggered
Today, the Medicare Trustees delivered to Congress their annual report on the financial operations and status of the program.
Medicaid Funding Reform: Impact on Dual-Eligible Beneficiaries
The Better Care Reconciliation Act (BCRA) would cap Medicaid funding to states. In this analysis, Avalere worked with The SCAN Foundation to examine how BCRA Medicaid changes would impact dual-eligible beneficiaries. We compare these outcomes to the impact of the House-approved American Health Care Act.
Avalere’s Take on the Quality Payment Program Proposed Rule
Today, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule that makes changes to the Quality Payment Program (QPP) for 2018, the second year of the program created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
21st Century Cures: What to Expect This Summer
The 21st Century Cures Act presents medical product manufacturers, patient groups, and advocacy organizations with a unique opportunity to plan for upcoming policy changes that are aimed at accelerating the pace of development and approval of new therapies.
Avalere to Participate in National Academies of Medicine Panel
On Tuesday, June 13, Christie Teigland, PhD, will participate in a panel discussion entitled “Measuring and Reporting Social Risk Factors” as part of a dissemination meeting on the report series “Accounting for Social Risk Factors in Medicare Payment,” sponsored by the National Academies of Medicine.
Avalere Deepens Focus on FDA Regulatory Matters with Three New Hires
Tom Kraus, who most recently served as the chief of staff at the FDA, will be joining Avalere as senior vice president.
Five Obstacles to Competition in the United States Biologics Market
Biosimilars have the opportunity to foster competition, but policy and market barriers limit the growth of a functioning market.
Avalere and FasterCures Co-Author Blog Post Featured in Health Affairs
Blog post features key learnings from the Patient-Perspective Value Framework.
Our Take on The President’s Budget for Fiscal Year 2018
Today, the Trump Administration released its budget for fiscal year 2018 (FY 2018). The budget provides the President's recommendations for how the Congress should fund the government and marks the beginning of the FY 2018 budget season.
VA Formulary Coverage Much More Limited than Ohio Medicaid
Across 8 therapeutic areas, the Veteran's Administration (VA) National Formulary covers 49 percent fewer drugs than Ohio's largest Medicaid managed care plan and 68 percent fewer drugs than the Ohio Medicaid preferred drug list (PDL).
Payer Insights on the Use of Patient Data
Avalere recently partnered with the National Pharmaceutical Council to examine payers' perspectives regarding the use of patient data and how it can be used to shape care delivery, improve system efficiencies, and achieve better health outcomes.
FasterCures Commits Seed Funding for Phase 2 of Patient-Perspective Value Framework (PPVF) Initiative
This week, FasterCures provided Avalere with a second round of seed funding to test, refine, and validate the PPVF.
Avalere’s Take on the Market Stabilization Final Rule
Today, the Centers for Medicare & Medicaid Services (CMS) released its final rule for market stabilization of the health insurance exchanges, following the departure of some health plans from the marketplace for the upcoming plan year.
Scott Peterson Joins Avalere as Vice President of Data Architecture
Scott Peterson, formerly Chief Information Officer at the Minnesota Department of Human Services, is joining Avalere’s Data Analytics and Development team.
Manufacturer’s Compassionate Use Policies: Companies with Posted Policies More Than Doubled Since September 2016
The 21st Century Cures Act requirement to post compassionate use policies may explain increase.
Final Report: The Impact of Medicare Advantage Data Submission System on Risk Scores
Avalere 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).
FDA Priority Review Voucher Programs: Incentive for Industry to Develop Novel Treatments
Extension of the Sunset Clause provides additional opportunity for the FDA to award vouchers and for transference of vouchers from recipients to other sponsors.
Risk-Bearing ACOs Growing in Popularity Under Medicare Programs
On January 18, 2017, the Centers for Medicare & Medicaid Services (CMS) announced the new Accountable Care Organization (ACO) participants in the Medicare Shared Savings Program (MSSP) for 2017.