An Avalere analysis found differences in the performance of low- and high-intensity prostate cancer episodes in the Oncology Care Model (OCM). High-intensity prostate cancer episode expenditures were consistently below the benchmark price while low-intensity episode expenditures were similar to the benchmark price. This finding is likely driven by the Centers for Medicare & Medicaid Services (CMS) methodology used to calculate benchmark prices but may also indicate participant success in controlling costs for these episodes.

• Maddi Davidson
• Brook Getachew
• Shalini Parekh
• Melissa Morley
• Omar Hafez
• Lance Grady

Consumers ages 50–64 could see higher exchange premiums starting in 2023 without extension of ARPA subsidies.

• Massey Whorley

As Congress considers the bipartisan infrastructure package and budget reconciliation agenda, the coming months are likely to include debate on what could be the most significant federal healthcare legislation in over a decade. Additionally, the Biden administration is expected to release several important healthcare rules this fall, including the details necessary to implement the new law banning surprise billing and regulations to protect and strengthen Medicaid and the Affordable Care Act (ACA).

• Matt Kazan
• Anjali Chhatre

Avalere’s analysis shows differences in payments between employer and non-employer Part D plans.

• Shruthi Donthi
• Kelly Brantley