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
Top Health Policy Stories of Summer 2016
While we technically have a few weeks of summer left, we decided to take a look back at the stories that were catching people's attention based on our website hits.
Avalere Analysis on MedPAC’s Proposed Part D Reforms to Modify Beneficiary Cost Sharing
Avalere recently analyzed two different Part D policy proposals outlined in The Medicare Payment Advisory Commission (MedPAC) June 2016 report to Congress.
CMS Takes on Risk Adjustment in Latest NBPP Proposal
In late August, CMS released its proposed Notice of Benefit and Payment Parameters (NBPP) for the 2018 plan year.
Quality Report for Rheumatoid Arthritis
Avalere recently analyzed the quality measure landscape for rheumatoid arthritis.
Quality Report for Schizophrenia
Avalere recently analyzed the quality measure landscape for schizophrenia.
The Inpatient Prospective Payment Systems (IPPS) FY 2017 Overview
Last Tuesday, August 2, the Centers for Medicare & Medicaid Services (CMS) released the FY 2017 IPPS final rule
Snapshot of Gubernatorial Elections and Outlooks
Recently, Avalere took a look at the gubernatorial elections happening this year, their outlooks, and where they stand on the Exchanges and the Medicaid expansion.
Costs of Care: Getting the Patient-Clinician Conversation Right
Avalere Supports the Robert Wood Johnson Foundation in Issuing Two Calls for Proposals
Commercial Uncertainty Remains as US Biosimilar Pipeline Matures
With the recent announcement of the U.S. Food and Drug Administration's (FDA) acceptance of a submission for approval of a second biosimilar to Remicade (infliximab), questions remain for biologics manufacturers, payers, prescribers, and others as to how a mature biosimilars pipeline will begin to evolve in the United States and whether a sustainable competitive specialty market will develop.
Key Takeaways from the FasterCures Value Assessment 2.0 Webinar
On June 1, Josh Seidman participated in a panel discussion hosted by FasterCures to discuss Avalere's collaboration with FasterCures to develop a patient-centric value framework.
CORRECTION: Early Analysis Finds 2017 Proposed Exchange Rates Exceed 2016 Increases But Vary Widely By State
Popular low cost options see smaller increases.
Side-by-Side Comparison of Clinton and Trump’s Healthcare Priorities
As we near the July conventions and the November election, the dialogue continues to ramp up on the latest policy proposals from the presumptive presidential nominees - Hillary Clinton and Donald Trump.
The Evolving Role of the Center for Medicare and Medicaid Innovation in Achieving Value-Based Payment Goals
The passage of the Affordable Care Act established the Center for Medicare and Medicaid Innovation (CMMI) to help advance new payment and delivery models.
Medicare Advantage: 2016 National Snapshot
In 2016, more than 18 of 56 million Medicare beneficiaries receive their benefits from Medicare Advantage (MA) plans. MA plans are private managed care organizations that contract with the federal government to coordinate care for Medicare beneficiaries.
A Conversation on Prescription Drug Pricing
As the discussion intensifies, one of Avalere's experts provides keen observations on what you need to know about this topic.
Avalere Health Collaborates with the Academy of Malnutrition and Dietetics on Malnutrition Quality Measures Project
Avalere Health has developed a set of malnutrition quality measures in collaboration with the Academy of Malnutrition and Dietetics. Embarking on a journey to improve care to malnourished patients, the collaboration spurred formal multi-stakeholder dialogues to be conducted.
2016 Exchange Plans Improve Access to Medicines Used to Treat Complex Diseases
An analysis from Avalere shows that more health insurance plans offered through the Affordable Care Act exchanges are making some drugs used to treat complex diseases—such as HIV, cancer, and MS—more accessible to patients in 2016 than in the previous years. Specifically, plans were less likely to place all drugs in a class on the highest cost-sharing tier.
Programs Contributing to HHS Meeting Its Alternative Payment Model Goal Largely Consist of Upside-Only Models
HHS confirms continued movement away from traditional FFS payments, yet significant work remains to move more providers away from upside-risk models and into downside-risk models.
While Progress Has Been Made, Barriers Still Impede Fully Interoperable Health Information Technology
On behalf of The Pew Charitable Trusts, Avalere conducted research to identify current barriers to interoperability and some of the best potential solutions in the current political and business environments.
Integrating the Patient Perspective into the Development of Value Frameworks
FasterCures and Avalere partner to develop a patient-perspective value framework.