News

Medicaid Networks More Than 60% Narrower Than Commercial in Some Areas

At a time when more Americans—particularly people of color—are enrolled in Medicaid, new Avalere analysis finds that provider networks for primary care and certain specialties in Medicaid are narrower on average than those of commercial plans in certain metropolitan areas, ranging from 63% smaller in Miami to 18% in New York.

Heather Flynn

Hospital Discharges to Home Health Rebounding, But SNF Volumes Lag

New Avalere Health analysis of Medicare fee-for-service (FFS) claims data reveals large decreases in skilled nursing facility (SNF) and home health care use following the widespread decline in inpatient hospitalizations amid the response to the COVID-19 pandemic. Avalere’s analysis further suggests that as inpatient procedures resume in some areas, the volume of inpatient hospital discharges to home health is starting to rebound, whereas the volume of discharges to SNF remains below 2019 levels.

States Choosing Healthy Adult Opportunity Program Will Need to Generate Savings to Stay Below Capped Funding Levels

New analysis from Avalere finds that states currently covering non-mandatory adult populations who choose to participate in the Healthy Adult Opportunity (HAO) initiative may need to generate up to 8% in Medicaid savings to keep spending below new capped funding levels.

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