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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Business Education for Healthcare Innovation
The healthcare delivery system is one of the most complex businesses in the country.
FDA and Sponsors Discuss Quality Challenges in the Breakthrough Therapy Pathway
Need to Know: On June 10, Friends of Cancer Research held a public meeting to discuss how sponsors and FDA may be able to expedite rate-limiting steps in Chemistry, Manufacturing, and Controls (CMC) and current Good Manufacturing Practices (cGMPs) for breakthrough therapy designated products, while ensuring an adequate supply of safe and efficacious product at the time of approval.
Lowest-Cost Exchange Premiums Remain Competitive in 2016; Consumers may be able to keep increases small by selecting a low-cost silver option
A new analysis from Avalere finds wide geographic variation in 2016 premium increases for individual market exchange plans, based on proposed rate filings in eight states where complete data is available.
Avalere White Paper: Hospital Acquisitions of Physician Practices and the 340B Program
Avalere recently researched the relationship between hospital participation in the 340B program and the recent trend of hospitals acquiring physician practices.
An Analysis of the Impact of Breakthrough Therapies on Government Spending
To evaluate public program spending on new medications in the drug development pipeline, Avalere projected the fiscal impact of 10 FDA breakthrough therapies to Medicare, Medicaid, and the health insurance exchanges created by the Affordable Care Act (ACA).
Quality Measures and Cancer Care: What You Should Know
Cancer is a burden to patients and the healthcare system. Last year, an estimated 1.6 million new cancer cases were diagnosed in the U.S and the latest figures estimate that 13.4 million people, about 4 percent of the U.S. population, live with cancer in the U.S.1
Patient Engagement: The Do-or-Die of Growing Alternative Payment Models
Avalere analyses show that more than 700 ACOs already operate in the U.S.
Upcoming Managed Care Regulation Will Impact Plans Serving 46M Medicaid Beneficiaries
Over the past four years, enrollment in Medicaid managed care has increased by 48 percent, with 46 million beneficiaries now receiving coverage through these plans. The government will soon update regulations that direct the plans providing this coverage.
Clarity on How Pharmaceutical Companies Can Communicate Data Could Spur Investment in Evidence Generation
New research from Avalere Health finds that 86% of pharmaceutical companies would invest more in studies to support the development of healthcare economic information if provided additional guidance on their ability to use this evidence with external audiences.
What’s on the Horizon for Bundled Payments?
We recently sat down Brian Fuller to discuss the latest developments that are occurring with risk models and bundled payments.
Spotlight On: Patient Engagement
Earlier this week, BioCentury featured guest commentary from Tanisha Carino and Reginald Williams about patient engagement.
Updated Breast Cancer Screening Recommendation Could Eliminate Guaranteed Coverage of Mammography for 17M Women
A new analysis from Avalere finds that 17 million women ages 40 to 49 could lose their guarantee of mammogram coverage, if new breast cancer screening guidelines from the United States Preventive Services Task Force (USPSTF) are finalized.
Better Shop Around: Out-of-Pocket Prescription Drug Costs in Covered California Plans
A new report by Avalere Health published by the California HealthCare Foundation
Focus on Value: Performance Contracting
Given the rapid evolution of the healthcare marketplace and increasing focus on delivery of value-based care, healthcare stakeholders across the spectrum are focused on appropriately managing risk.
Five Key Principles for Maximizing Value in the Healthcare System
A new report examines the scientific evidence regarding how new payment models and interventions are helping to shift the healthcare system from one that rewards volume to one that rewards value.
UHC Announces Coverage of Video Provider Consultations
Recently, United Healthcare (UHC) announced that it will now cover video consultations from three platforms: Doctor on Demand™, American Well's Amwell™, and Optum's NowClinic®.
What You Need to Know about the Pioneer ACO Announcement
This past Monday, CMS announced the findings of a recent analysis which found that $384 million was saved over the first two years in the Pioneer ACO program. Most of the savings was accrued in the first performance year, totaling $279.7 million.
Individual Mandate Penalty May Be Too Low to Attract Middle-Income Individuals to Enroll in Exchanges
A new analysis from Avalere finds that the penalties associated with the individual mandate, which grow in 2015, might be too low to attract enrollment, particularly among middle-income, healthy individuals.
Leading Cancer Centers May Be More Widely Included in Exchange Networks than Expected
A new survey conducted by Avalere and the National Comprehensive Cancer Network® (NCCN®) shows that exchange plan participation by the nation's leading cancer centers is highly varied, but may be better than initial 2014 reports suggested.
Stakeholder Input in the Harmonization of U.S. and Canadian Drug Development Regulations
On April 13, the Federal Register announced a public meeting entitled "Preparations for International Conference on Harmonization Steering Committee and Expert Working Group Meetings in Fukuoka, Japan."