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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Avalere’s Take: Exchange Open Enrollment Figures to Date
With less than a month to go in 2015 exchange open enrollment, the Department of Health and Human Services (HHS) today released new estimates of sign-ups to date. But where do we really stand?
Avalere and the Alliance Release Home Health Chartbook
Avalere Health & The Alliance for Home Health Quality & Innovation released a Chartbook as an overview of home health patients, workforce, organizational trends, and economic contributions.
Avalere Analysis: New Benefit Designs in Exchange Plans Make Determining Out-of-Pocket Costs for Specialty Drugs Challenging
Determining the cost or co-payment of a specialty drug-high-cost drugs typically used to treat complex diseases like cancer or rheumatoid arthritis-has always been complicated.
MAP Releases Draft 2014-2015 Measure Recommendations; More Conservative Than in Year’s Past
On Tuesday, December 23, the Measure Applications Partnership (MAP) released draft recommendations for inclusion of measures in federal programs.
Recent Insights from the Avalere Center for Payment & Delivery Innovation
The Avalere Center for Payment & Delivery Innovation is a leading voice in helping organizations succeed in a value-based healthcare environment.
Dialogue Proceedings: Launching the Malnutrition Quality Improvement Initiative
Despite its notable negative impact on patient outcomes and costs of care, malnutrition is an area that has largely remained unaddressed by national programs and initiatives.
New Web Tool Helps Consumers Estimate Out-Of-Pocket Costs In Marketplace Plans
PuttingPatientsFirst.net uses Avalere Analytics to Educate Patients about Exchange Choices
Avalere Analysis – Exchange Enrollment Outlook: 10.5 Million to Sign Up by End of 2015
A new analysis by Avalere Health estimates that exchange enrollment will total 10.5 million people by the end of 2015, though enrollment could fluctuate up or down by approximately 1 million individuals.
Avalere Analysis: Consumers Should Look at Maximum Out-of-Pocket Limits & Deductibles in the Exchanges
New analysis from Avalere Health finds that 74 percent of Silver plans offered on exchanges have maximum out-of-pocket limits below what is required by law.
UDI Lineage – UDIs Not Linked When a Device Changes Ownership, Potentially Causing Patient Harm and Provider Confusion
FDA passed the Final Rule for Unique Device Identification (UDI) on September 24, 2013 with the rollout of Class III devices one year later.
Exchange Plans Increase Costs of Specialty Drugs for Patients in 2015
A new analysis from Avalere Health finds that patients accessing specialty medications - drugs often used to treat life threatening illnesses, such as cancer, rheumatoid arthritis, or multiple sclerosis - through exchange plans are more likely to experience higher out-of-pocket costs in 2015 than in 2014.
Avalere Analysis: Most Popular Exchange Plans Are Increasing Price
New analysis from Avalere Health finds that the most popular exchange plans* in 2014 increased premiums by 10 percent on average in 2015.
Avalere Medicaid Expansion Map – November 2014
28 States & DC Are Expanding Medicaid Eligibility; Others May Make Decisions to Expand.
Avalere Analysis: 2015 Exchange Premium File
New analysis from Avalere Health examines the 2015 Federal Exchange Premium File.
Avalere Analysis: Medicare Beneficiaries Will Pay Higher Out-Of-Pocket Costs As PDPs Increase Use Of Coinsurance In 2015
First Time in History of Part D, All PDPs Will Incorporate a Specialty Tier
Avalere Analysis: Reactions to the 2014 Midterm Elections
The following is a list of Avalere Health analyses and reactions to Tuesday's midterm elections.
CMS Releases Calendar Year 2015 OPPS/ASC Final Rule
On October 31, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2015 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule.
CMS Releases CY 2015 MPFS Final Rule; Rates Set Through March with SGR Issue Looming
On October 31, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2015 Medicare Physician Fee Schedule (MPFS) final rule.
CMS Finalizes Flat Payment and New Quality Measures for Dialysis Facilities
In the Calendar Year (CY) 2015 End Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule released on October 31, the Centers for Medicare & Medicaid Services (CMS) finalized a 2015 base per treatment rate of $239.43, up slightly from $239.02 in CY 2014.
Avalere Analysis: Impact of the 2014 Elections on Healthcare
Avalere Health has identified key issues to monitor during tomorrow's midterm election.