Deferral of care during the COVID-19 pandemic is resulting in fewer claims and diagnoses among Medicare Advantage (MA) enrollees, which could lead to a 3%–7% reduction in 2021 risk scores and lower plan payments in 2021.
Tune into the tenth episode of our series of podcasts that focuses on COVID-19, which will discuss impacts on provider performance in 3 critical segments. In episode 10 Part I, Avalere experts from the Center for Healthcare Transformation will discuss the impacts of COVID-19 on measures, specifically related to cardiovascular disease, diabetes, obstetrics and gynecology, and primary care disease management.
Avalere analysis of Medicare fee-for-service (FFS) hospital stay claims with associated COVID-19 diagnoses finds that total US healthcare system costs for hospitalizations due to COVID-19 could range from $9.6B to $16.9B in 2020.
Avalere’s issue brief highlights real-world examples of how cost of care can be woven into physician-patient conversations and how it can improve dialogues.
While the COVID-19 pandemic continues to spread around the world, FDA has been balancing taking action to accelerate development of COVID-19 therapeutics and vaccines, while concurrently maintaining day to day activities to ensure proper oversight of current and future products on the market for all other unmet medical needs.
The novel coronavirus (COVID-19) was first reported in Wuhan, China, on December 31, 2019, and within a month was declared a public health emergency of international concern (PHEIC) by the World Health Organization (WHO).
Avalere analysis finds Medicare incurred $106.4 billion in 2016–2018 treating diseases potentially preventable with inline vaccines and select pipeline vaccine candidates. Those diseases also resulted in beneficiary costs of approximately $9.6 billion during the same time period.
In this third episode, Sam Ferguson, a consultant in Avalere’s Market Access practice, along with Allison Petrilla, a managing director in Avalere’s Health Economics and Advanced Analytics practice, and Amy Schroeder, a senior consultant in Avalere’s Market Access practice, discuss how stakeholders are utilizing and translating real-world evidence (RWE) into value for oncology.
In the second episode, Sam Ferguson and Michael Kearney, consultants in Avalere’s Market Access practice, along with Megan Olsen, an associate principal in Avalere’s Policy practice, will discuss how to appropriately define the value of durable therapies in oncology and how to pay for those therapies within our current healthcare system.
As COVID-19 forces the healthcare system to reprioritize patients and resources, providers delivering behavioral health services may be left with insufficient means to serve the population. Medicaid programs may observe increased demand for behavioral health services but may be ill-equipped to support beneficiaries.
1115 Waivers approved by CMS allow state Medicaid programs to better address substance use disorders among beneficiaries.
Avalere experts explored the future role of telehealth and how organizations can help shape and take advantage of its increased utilization.
In the first episode, Sam Ferguson and Biruk Bekele, consultants in Avalere’s Market Access practice, along with Milena Sullivan, a principal in Avalere’s Policy practice, will discuss how stakeholders are defining value in oncology.
On May 13, Avalere experts discussed key issues and considerations for the healthcare industry as millions of Americans shift in and out of new sources of coverage due to COVID-19.
COVID-19 continues to spread nationwide, and individuals with social risk factors and underlying chronic conditions are at highest risk for severe illness.
Avalere experts discussed new data analytics and health economics and outcomes research approaches for evaluating key value-based topics in healthcare, including novel curative therapy affordability and access, alternative payment models, and the increasingly important role of real-world evidence in healthcare decision-making.
As control of the Medicaid drug benefit continues to shift from managed care organizations to states, manufacturers should understand unique benefit dynamics in each state, particularly as Medicaid enrollment is likely to increase amid the COVID-19 pandemic.
A potential recession due to job losses and business closings as a result of COVID-19 will cause shifts in the payer mix and, ultimately, revenue dynamics for physician practices.
Citing alarming statistics that nearly 1 of every 2 older Americans is at risk of malnutrition and that disease-associated malnutrition in older adults is estimated to cost nearly $53 billion annually, a broad group of advocates has presented a updated roadmap for a continuing national effort to help millions of Americans who suffer from malnutrition or could be at risk as they age. The expected rising incidence of malnutrition amidst the current COVID-19 pandemic makes it even more critical to advance solutions across all points of care.
The COVID-19 pandemic has revealed several weaknesses in our country’s web of safety net programs. Although the virus may not discriminate, it may exacerbate existing health inequities driven by social determinants of health (SDOH).
