State-Run Reinsurance Programs Reduce ACA Premiums by 19.9% on Average
New analysis from Avalere finds that states with their own reinsurance programs reduce individual market premiums by 19.9% on average in their first year.
Top 4 Steps to Ensure Operational Readiness for RAPS to EDS Transition
As CMS continues to transition from the Risk Adjustment Processing System (RAPS) to the Encounter Data System (EDS) for Medicare Advantage (MA) risk score calculation, plans must evaluate operations and close gaps to minimize the impact of risk score differences using this claims data source.
Everyone Has a Job to Do in Reducing Costs
Today continues a steady diet of healthcare cost hearings with committees on both sides of Capitol Hill digging into the issue.
E4 – Recommendations for How to Overcome Common Barriers When Implementing Cost-of-Care Conversations
Tune in to hear the last episode in our 4-part series that provides clinicians with recommendations for how to overcome common barriers when implementing cost-of-care (CoC) conversations. Peter Ubel will talk with Avalere’s Katherine Steinberg on actionable tips that primary care clinicians can use to help address potential barriers and challenges related to implementing CoC conversations in the clinical setting. Support for this podcast was provided by the Robert Wood Johnson Foundation and the New York State Health Foundation (NYSHealth). The views expressed here do not necessarily reflect the views of the foundations.
Medicare Reimbursement of Virtual Care Delivery and Remote Monitoring
Beginning in 2019, CMS will reimburse for 5 codes relating to virtual care delivery and remote monitoring
E3 – A Guide to Integrating Cost-of-Care Conversations into Workflow
Tune in to hear the third episode in our 4-part series that provides clinicians with actionable approaches for integrating cost-of-care conversations into workflow. Nora Henrikson will talk with Avalere’s Katherine Steinberg on 3 pathways that clinicians can use to best integrate cost of care conversations into their clinical workflows. Support for this podcast was provided by the Robert Wood Johnson Foundation and the New York State Health Foundation (NYSHealth). The views expressed here do not necessarily reflect the views of the foundations.
Critical Steps for Post-Acute Care Organizations to Succeed in Value-Based Care
Tune in as Avalere experts interview each other on hot topics in healthcare. In this discussion, Avalere Managing Director of Health Plans and Providers, Fred Bentley is interviewed by Alexa Trost, Associate, on the current state of value-based care across the health care landscape and critical steps post-acute care organizations needs to take to to succeed in this environment.
HHS Proposed Changes Could Reduce ACA Coverage and Increase Premiums
New analysis from Avalere finds that exchange plan sign-ups could decline by 1.1 million, while premiums could increase by 6.3%, by 2025 should HHS finalize recently proposed changes to auto-reenrollment in the exchange and the calculation of tax credit subsidies.
E2 – Quick Tips for Clinicians on How to Talk with Patients About the Expected Costs of Care
Tune in to hear the second episode in our 4-part series that provides clinicians with actionable tips and a simple framework for how to structure cost-of-care (CoC) conversations with their patients. Susan Perez and Maria Pisu will talk with Avalere’s Katherine Steinberg on strategies that clinicians can use to discuss costs with their patients. Support for this podcast was provided by the Robert Wood Johnson Foundation and the New York State Health Foundation (NYSHealth). The views expressed here do not necessarily reflect the views of the foundations.
The Growing Role of Digital Health and How It’s Shaping Patient Engagement
Tune in as Avalere experts interview each other on hot topics in healthcare. In this discussion, Avalere Consultant, Priya Gaur is interviewed by Camille Boler, Associate, on the increasing role of digital health and how it's influencing patient engagement.
2019 Medical Device Industry Outlook: Get a Clearer View
Avalere experts hosted a lively discussion on the 2019 outlook for the medical device industry.
E1 – Why Should Primary Care Clinicians Routinely Talk with Their Patients About the Expected Costs of Care?
Tune in to hear the first episode in our 4-part series that focuses on how clinicians and other care team members can improve the quality and frequency of cost-of-care (CoC) conversations. To kick-off this series, Gwen Darien and Jim Hardee, will talk with Avalere’s Katherine Steinberg on why clinicians should speak with their patients about the expected costs of their care. Support for this podcast was provided by the Robert Wood Johnson Foundation and the New York State Health Foundation (NYSHealth). The views expressed here do not necessarily reflect the views of the foundations.
ACIP Recommendations Shift Pneumococcal Vaccination Patterns
New research from Avalere finds that the provision of pneumococcal conjugate vaccines increased immediately after ACIP’s 2014 recommendation to add the vaccine to the routine immunization schedule for older adults.
Avalere Welcomes Jason Altmire as Senior Advisor
Former U.S. Congressman Jason Altmire has joined Avalere Health as a senior advisor, offering his deep understanding of the policy-making process to inform business strategy.
Avalere Launches Podcast Series for Clinicians on How to Talk to Patients About Costs of Care
In February, Avalere is releasing a 4-part podcast series that focuses on how clinicians and other care team members can improve the quality and frequency of cost-of-care conversations with patients.
Are Health Plans the Future of Public Health?
The transition from old-guard payer to wellness company is underway–and moving rapidly.
CMS Highlights Potential Changes that Could Restrict Access to and Increase the Costs of Certain Brand Drugs to Obamacare Enrollees
The Centers for Medicare & Medicaid Services released the proposed Notice of Benefit and Payment Parameters (NBPP) for the 2020 plan year. The rule could limit exchange plan enrollees' access to certain brand name drugs and increase the out-of-pocket costs within plans.
Drug Importation Proposals Gain Traction but Raise Cost and Operational Questions
The costs of ensuring the safety and efficacy of imported drugs and preventing the entry of counterfeit products are among the many factors that must be weighed against any potential savings from a drug importation program.
Landscape for Diagnostics Will Continue to Change in 2019
While precision medicine is expected to revolutionize patient therapy, the increasing complexity of diagnostics is leading policymakers to revamp the way these tests are regulated and paid for.
Emerging Influenza Vaccine Technologies Stand to Improve Vaccination Rates
Nearly 80,000 people died during the 2017–2018 influenza season. Only 37% of adults were vaccinated. Several novel emerging products could make vaccination more accessible and effective, potentially reshaping the market and lowering influenza disease burden.