Tune into the seventh episode of our series that focuses on COVID-19. In episode 7, Avalere experts from the Health Plans and Provider’s practice discuss the short- and long-term implications for post-acute care as a result of COVID-19.
To protect the public’s health during the COVID-19 pandemic, the Food & Drug Administration (FDA) released guidance expanding the availability of digital health therapeutic devices and applications for psychiatric disorders by clarifying which regulatory requirements it does not plan on enforcing as well as which products do not necessitate FDA oversight. This guidance intends to limit extraneous contact between patients (users) and providers by providing regulatory flexibility for low risk products. The policies will last until the national public health emergency ends.
Avalere analysis finds that former Vice President Joe Biden’s proposal to lower the Medicare eligibility age from 65 to 60 could increase access to Medicare coverage for an additional 23 million individuals.
As COVID-19 deaths increase, the FDA is evaluating and considering approval of treatments more quickly, but the rush to find treatment options is creating new access considerations for patients and providers.
As COVID-19 continues to stress the US healthcare system, pharmacists and retail pharmacies may help respond to the pandemic.
Approximately ⅓ of physician services payments are eligible for telehealth reimbursement under Medicare (fee-for-service) FFS through existing Center for Medicare and Medicaid Services (CMS) guidance as of January 2020, in addition to temporary coding guidance specific to COVID-19 effective as of March 1, 2020. Avalere’s analysis highlights the immediate potential for specific physician specialties to utilize telehealth based on temporary flexibilities regarding which procedures are eligible for telehealth reimbursement.
As of 2018, almost 70% of hospitals in the United States are not-for-profit entities according to the American Hospital Association (AHA).
The large-scale disruptions resulting from COVID-19 are significantly reshaping how patients receive care. In particular, patients taking infused and injectable drugs administered by a healthcare professional at a physician office, infusion center, or hospital outpatient department now face greater challenges receiving their medications.
Although influenza disease burden is high, vaccine uptake remains low.
An Avalere analysis finds that Medicare Part D plans allow $0 cost-sharing for select vaccines just 4% of the time, likely affecting immunization uptake.
Avalere analysis finds that in the top 25 US counties with highest number of COVID-19 diagnoses, two-thirds of Medicare beneficiaries have 1 or more high-risk medical conditions.
Avalere experts discuss how the COVID-19 pandemic has affected oncology care and delivery, and the Oncology Care Model (OCM).
The COVID-19 pandemic will have ongoing, market-wide implications as Medicare Advantage (MA) plans contend both with responding to the virus and the disruption to their normal activities.
On April 7, Gillian Woollett authored a Health Affairs blog piece with Ge Bai from the Johns Hopkins Carey Business School and Bruce Pyenson from Milliman about the role that testing plays in recovering from the COVID-19 pandemic.
The FDA has adjusted its priorities in response to the COVID-19 pandemic and the agency is expediting decisions on testing, therapies, and vaccines on a daily basis.
As the COVID-19 pandemic unfolds, stakeholders across the healthcare system are facing new realities that will affect the environment in which drugs are commercialized and accessed.
In response to the novel coronavirus (COVID-19) pandemic, a majority of state legislatures have either suspended their ongoing legislative sessions or adjourned sine die, which marks the definitive end of a state’s session, earlier than originally scheduled.
In response to the COVID-19 pandemic, FDA has announced actions that may have much broader implications for drug development, lifecycle management, and oversight.
Globally, the need to flatten the epidemic curve of COVID-19 cases has become the top public health priority to save lives and minimize the burden on the health care system. In the absence of treatments and prophylactics for the novel coronavirus, social distancing and quarantine strategies continue to be implemented in the US.
The Centers for Medicare & Medicaid Services (CMS) issued a new Interim Final Rule (IFR) that is intended to allow additional beneficiaries, especially those who are at high-risk, to receive home infusions amid COVID-19 transmission concerns. Specifically, the CMS clarified the definition of “homebound” under the Medicare Home Health Benefit and temporarily suspended enforcement of the National and Local Coverage Determinations (NCD and LCD) related to home infusion services. Uncertainties remain as to how these new flexibilities will be utilized, as well as how these flexibilities could impact treatment outcomes.
