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 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.
Avalere & the SCAN Foundation Release Person-Centered Care Roadmap
On October 29, Avalere Health and The SCAN Foundation released a roadmap on person-centered care sustainability, offering organizations specific examples of person-centered care models leading towards short and long-term savings.
Avalere Analysis: 2014 Governors’ Races Could Lead to More Medicaid Expansion
In at least six states, Medicaid programs could be expanded as a result of the outcome of the 2014 governors' races.
Avalere Medicaid Expansion Map – October 2014
As of October 28, 2014, 28 states and D.C. have decided to expand Medicaid eligibility; more may expand next year.
JAMA Study Shows Drug Labels Rarely Demonstrate Clinical Utility
On October 13, JAMA Internal Medicine published a study on the available clinical validity and clinical utility of pharmacogenomic information included in drug labels.
Avalere Analysis: Medicaid Managed Care Enrollment Set to Grow by 13.5 Million
A new analysis from Avalere Health projects that enrollment of Medicaid and Children's Health Insurance Program (CHIP) beneficiaries in managed care - i.e., state payment of private companies to provide benefits - will increase by 13.5 million individuals from 2013 to 2016.
Part D Formulary Data Reveals Continued Shift to Coinsurance by Plans, With All PDPs Designating a Specialty Tier in 2015
On Oct. 8, the Centers for Medicare & Medicaid Services (CMS) posted detailed information regarding formulary structures, drug coverage, cost-sharing amounts, and utilization management (UM) trends across standalone Medicare prescription drug plans (PDPs) for the 2015 benefit year.
8.7 M Additional Medicaid Beneficiaries Enrolled as a Result of the Affordable Care Act
On Oct. 17, the Centers for Medicare & Medicaid Services (CMS) released their most recent report detailing Medicaid enrollment attributable to the Affordable Care Act (ACA).
Avalere Health Releases Enhanced Recovery White Paper
"On June 10, 2014, the Center for Medical Technology Policy (CMTP) in collaboration with Avalere Health hosted a multi-stakeholder forum in Baltimore, Maryland, to discuss potential challenges and opportunities to accelerate the adoption of enhanced recovery protocols (ERPs) in the U.S.
CMS Report Shows Medicare Advantage Plan Performance and Quality Continue to Improve
On Friday, the Centers for Medicare & Medicaid Services (CMS) released data on Medicare Advantage (MA) plan performance and quality.
EMA Posts Final Decision on Clinical Trial Data Transparency
After a year and a half of discussion, revisions and more than 1,000 various stakeholder comments, the European Medicines Agency (EMA) just announced its final decision on clinical trial data transparency.
Barriers to the Implementation of Patient-Reported Outcome Based Performance Measures for Assessing Quality
The pressure to constrain healthcare costs, maximize clinical quality and improve patient experience has stimulated new approaches to measuring value, and places greater focus on the use of patient-reported outcome (PRO) based performance measures.