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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State-Based Exchanges Saw Higher Attrition from 2014 to 2015 Than Federally-Facilitated Exchanges
Exchanges run by the federal government both retained a higher percentage of 2014 enrollees and enrolled a higher percentage of new enrollees in 2015 than states that run their own exchanges, according to a new Avalere analysis.
New Trends and Analysis for ACO Participants
The recent addition of 89 Accountable Care Organizations (ACOs) to the Medicare Shared Savings Program (MSSP) coupled with HHS' January announcement on transitions to value-based care highlight payment and delivery innovation's gathering momentum in federal health reform.
Access Avalere’s Latest Research on Brand-Name Prescription Drug Spending
Avalere released its latest report today, which highlights current brand-name prescription drug spending and projections for federal healthcare programs (Medicare, Medicaid, TRICARE and VA).
Insider’s Take on This Week’s MEDCAC Panel
We recently sat down for a Q&A with Avalere Director and MEDCAC panelist, Dr. Lakshman Ramamurthy, to get his take on the MEDCAC panel that happened earlier this week. Here's what he had to share.
Exchanges Struggle to Enroll Consumers as Income Increases
New analysis from Avalere finds that while exchanges have succeeded in enrolling very low-income individuals, they continue to struggle to attract middle and higher income enrollees.
New Avalere Analysis Examines the Unintended Consequences of “Hold Harmless” Rules in New Jersey
A new Avalere analysis finds that New Jersey's "hold harmless" regulations that apply when health plan members involuntarily use out-of network (OON) providers may not protect consumers as intended and, instead, have the unintended consequence of driving up healthcare spending in the state.
Sixty Percent of Medicare Advantage Enrollees Now in Plans with Four or More Stars
New analysis from Avalere finds that the proportion of Medicare Advantage (MA) beneficiaries enrolled in plans with 4 or more stars climbed from 38 percent in 2014 to 60 percent in 2015.
Listen In: QMN Webinar Archive
Missed our webinar on Tuesday?
Discussion Aids Reduce Spending and Improve Patient Outcomes for Medicare Beneficiaries
Avalere recently partnered with Third Way to estimate the cost savings of advancing the use of medical decision aids for Medicare beneficiaries, which would allow for shared decision-making between physicians and patients in preference-sensitive care.
Recap: Pharmacy Quality Alliance’s February 2015 Quality Forum
Avalere Health led the Pharmacy Quality Alliance's February 2015 Quality Forum Lecture entitled: A Look Ahead at 2015.
Avalere Observations: Impact of King v. Burwell & Potential Fixes
Today, the U.S. Supreme Court will consider whether it is legal for consumers in states with a federal exchange to receive tax credits to subsidize monthly premiums for plans purchased through the exchange.
Lessons Learned from Blue Cross Blue Shield of Massachusetts’ Alternative Quality Contract as HHS Explores Different Payment Models
As healthcare leaders and policymakers look to curb spending and improve quality, they should examine models like the Alternative Quality Contract (AQC), according to a new paper by Avalere.
Nearly 7.5 Million Consumers Could Face Premium Increases as a Result of Supreme Court King v. Burwell Ruling
Majority of affected enrollees would be exempt from individual mandate
California Exchange Formularies Offer Broad Coverage for Commonly Used Drugs
In a new analysis published by the California HealthCare Foundation, Avalere researchers found that Covered California plans provided comprehensive access to the most commonly used drugs.
Disease Matters: Comparing Prescription Drug Benefits in Covered California Plans
A new report by Avalere Health published by the California HealthCare Foundation
2015 Industry Outlook
Avalere hosted its 2015 Outlook webinar last week, which featured Tanisha Carino, Lindy Hinman, Ellen Lukens and Josh Seidman.
Avalere Analysis: Exchange Benefit Designs Increasingly Place All Medications for Some Conditions on Specialty Drug Tier
New analysis from Avalere Health finds that some exchange plans place all drugs used to treat complex diseases - such as HIV, cancer, and multiple sclerosis - on the highest drug formulary cost-sharing tier.
Avalere Medicaid Expansion Map – February 2015
28 States & DC Are Expanding Medicaid Eligibility; Others May Decide to Expand
Avalere’s Take: President Obama’s FY2016 Healthcare Budget
Today, the President released his Budget for the 2016 Fiscal Year. Avalere Health offers the following observations.
Avalere White Paper: A Multi-Stakeholder Vision for Patient-Centeredness in New Payment and Delivery Models
Avalere released its latest white paper on patient-reported outcomes (PROs) today in collaboration with leaders from patient, payer, health information technology, product development and research communities.