An analysis from Avalere Health finds that 12 state-based exchanges1 have enrolled about 3 percent of their expected 2014 exchange participants. Together, the 12 states have enrolled 49,100 people in exchanges based on data released by the states, as of Nov. 10. By the end of 2014, Avalere projects these states will account for 1.4 million exchange enrollees.
With a population of more than 26 million people, Texas is important to achieving the Obama administration's desired exchange enrollment.
In September, Arkansas received approval from the federal government to expand Medicaid using a premium assistance model or "private option" for 2014 through 2017.
On Oct. 30, CMS released a final decision memo on ventricular assist devices (VADs) used for bridge to transplant (BTT) and for destination therapy (DT).
Avalere experts to present at ISPOR Dublin's Poster and Workshop sessions.
On Oct. 24, CMS released its final program integrity standards rule, detailing: advance payments of the premium tax credit (APTCs) and cost-sharing reductions (CSRs); the premium stabilization programs; issuers offering coverage in the Federally Facilitated Marketplace; and standards for enrollee satisfaction survey vendors.
On Oct. 30, HHS sent a letter to Rep. McDermott, R-Wash., indicating that it does not consider qualified health plans (QHPs) purchased through insurance exchanges to be federal healthcare programs.
On Oct. 28, CMS released the calendar year (CY) 2014 benefit parameters for Medicare Parts A and B, which cover hospital inpatient and all outpatient drugs and services, and begins Jan. 1, 2014.
On October 24, Janet Woodcock, Director of the Center for Drug Evaluation and Research (CDER) at FDA, issued a statement indicating the Agency's intent to recommend reclassifying hydrocodone combination products from Schedule III to Schedule II products.
A new analysis from Avalere Health found that the number of applications submitted to date for exchange coverage exceeded comparable enrollment in Medicare Part D over the same time period during each program's launch.
The share of Medicare Advantage (MA) plans with a star rating of 4 stars or higher in 2014 (43 percent) will increase substantially relative to 2013 (27 percent) according to a new Avalere Health analysis of the Centers for Medicare & Medicaid Services' (CMS) recently released data on 2014 plan quality performance.
In early October, CMS released the Medicare Part D plan formulary and cost-sharing information for the 2014 benefit year.
Prime Therapeutics, America's largest privately held PBM, conducted a study examining member use of cost-sharing assistance programs across a variety of specialty drugs during the first half of 2013.
As regulators struggle to find answers to differing needs across the healthcare sector, patients are becoming a more integral part in shaping policy.
Consumers in 30 states (60%) will have the option of at least one plan operating as both a qualified health plan (QHP) in the health insurance exchange and as a Medicaid managed care organization (MMCO), according to an Avalere analysis.
Insurance exchanges were set to launch October 1, but technical glitches and enrollment delays have plagued most exchanges.
The Centers for Medicare and Medicaid Services (CMS) posted the star ratings for 2014 Medicare Advantage (MA) and Part D plans on the Medicare.gov website. Avalere Health is available to answer questions about this new information.
On September 30, CMS posted revised gapfill prices for molecular pathology Current Procedural Terminology (CPT®) codes, including calculations of the 2014 National Limit Amounts (NLAs).
Express Scripts Inc., the world's largest PBM for employers and health plans, recently released a list of 44 drugs that they will now exclude from coverage beginning January 1, 2014.
As molecular diagnostics become more common in treating certain diseases - especially cancer - their reimbursement will be an important part of value messaging for many drug therapies.
