2019 State Elections: What to Watch in Healthcare Policy
Healthcare policy remains a top priority for both voters and policymakers in 2019 and has been a key part of campaign platforms.
4 Things Hospital Executives Need to Know About Post-Acute Care
Despite the oft-repeated mantra that provider collaboration and care coordination are the bedrock of a more rational and cost-effective healthcare system, relationships between hospitals and post-acute care providers remain largely fragmented and uncoordinated.
Free Exchange Plan Options Are Available to Many Low-Income Consumers for 2020
New analysis from Avalere finds that over 96% of counties with exchanges operated by HealthCare.gov have free plan options for low-income consumers.
Opportunities to Integrate Social Determinants of Health into Healthcare Delivery
The National Academies issued a report identifying several key factors and recommendations for integrating social care into healthcare delivery.
5 Key Trends from the 2020 CMS Star Ratings Report
Join Avalere experts on our webinar on October 29, 2019, to unpack CMS’ 2020 Star Ratings and look at what’s to come for 2021.
Proposed Radiation Oncology Model Could Lower Payments for Treating Prostate Cancer
New analysis from Avalere finds the proposed case-mix adjustment for the radiation oncology model underestimates payments for prostate cancer .
3 Trends to Watch in this Medicare Open Enrollment Season
As Medicare Advantage enrollment grows and benefits continue to evolve, beneficiaries must keep pace with these changes and investigate plan options amidst current healthcare debates.
Avalere’s Home Health Expertise Featured in AHHQI Chartbook
For the last several years, Avalere has worked with the Alliance for Home Health Quality and Innovation (AHHQI) to analyze the ever-changing home health landscape.
Issue Brief: OOP Costs Among Medicare Part D Enrollees Reaching the Catastrophic Threshold
As policymakers consider reforms to the Part D benefit to address rising out-of-pocket (OOP) costs by adding a maximum OOP cap, an Avalere analysis examines the types of beneficiaries mostly likely to be helped by such a policy.
What’s Next for Biologics Under USMCA?
The USMCA’s intellectual property provisions add additional layers of ambiguity to the already complex issues surrounding biological product exclusivity and its future in US law.
Location of Measles Cases Linked to Geographies Where Non-Medical Exemptions for Vaccines Are Clustered
Since the 1980s, all 50 states have used immunization requirements as a condition of school entry to protect the public’s health from vaccine-preventable diseases.
Tom Kornfield Returns to Avalere Health, Expanding Firm’s Depth in Medicare Policy
Healthcare industry veteran brings decades of Medicare Advantage, Part D, risk adjustment, and business expertise to payer, life sciences, and provider clients.
7 State Policy Trends that May Shape Cancer Care in 2020
State healthcare legislation often holds important implications for high-value and high-cost drugs, such as those used to treat cancer patients.
Takeaways from NASHP: What’s Next in the States in 2020
Avalere’s state policy team recently attended the National Academy for State Health Policy’s (NASHP) Annual Conference for 3 days of interactive state health policy discussions and the facilitation of a roundtable on the direction of telehealth in the states.
New Innovations in Healthcare Aim to Address Social Determinants of Health
A wide variety of health plans, provider networks, and national corporations have recently developed and announced innovations and strategies to expand access to healthcare and to address needs that promote health across communities.
CMMI Program Savings Fall Below CBO’s 2016 Projections
CMMI’s impact on Medicare spending has so far not reached earlier projections by the Congressional Budget Office, demonstrating the difficulty in projecting savings from new and unknown alternative payment models.
E3 – Avalere Insights on Recent CMS Proposed Payment Rules: ESRD PPS and Quality Incentive Program
Tune in to hear the final episode in our 3-part series that focuses on CMS’s most recent proposed payment rules. In episode 3, we’ll be focusing on the End Stage Renal Disease (ESRD) Prospective Payment System, with a focus on proposed payment changes for innovative drugs, supplies, and equipment and updates to the Quality Incentive Program (QIP).
E1 – Avalere Insights on Recent CMS Proposed Payment Rules: OPPS
Tune in to hear the first episode in our 3-part series that focuses on CMS’s most recent proposed payment rules. In episode 1, we’ll be focusing on the outpatient prospective payment system proposed rule, more informally known as the OPPS.
Maximizing Access in an Evolving Policy and Payer Landscape
Manufacturers currently face an almost-unprecedented level of uncertainty in developing contracting strategies for the coming plan years. Avalere’s combination of policy and commercialization expertise, paired with its data capabilities, allow us to support life sciences companies understand this challenging landscape to ensure access to innovative therapies for their patients.
3.7M Part D Beneficiaries Are Projected to Reach the Catastrophic Phase in 2020
As policymakers consider reforms to Part D, new Avalere analysis shows that congressional proposals to cap out-of-pocket (OOP) costs in the catastrophic phase are likely to reduce OOP for many beneficiaries