Matt Kazan advises health plans, life sciences clients, and patient organizations as they navigate the policy landscape, focusing on Medicare Part D and Medicare Advantage, and implementation of the Inflation Reduction Act.
In recent projects, Matt helped life sciences companies understand and prepare for the IRA’s impacts on their products by organizing internal workshops with cross-functional teams to help clients align on IRA response strategies and providing data analytics to support those strategies. Matt has also helped manufacturers plan CMS engagement strategies so they can influence the IRA’s implementation. During congressional debate over the IRA, Matt also supported clients seeking to engage members of Congress by providing data, legislative text, and supporting materials to help clients deliver persuasive policy arguments to key members. Matt also provides leadership for Avalere’s Policy Edge subscription product, which surveys health policy legislative and regulatory experts to assist clients in anticipating future policy activity.
Before joining Avalere, Matt spent more than a decade on staff for the US Senate Committee on Finance under Senators Max Baucus and Ron Wyden. As Senior Health Policy Adviser, Matt served as the lead adviser on major Medicare issues, including Medicare Part D, Medicare Advantage, drug reimbursement across all Medicare, chronic disease, dual-eligible beneficiaries, post-acute care, the Medicare Shared Savings Program, and Medicare and Medicaid program integrity. Matt was involved in crafting and negotiating the Affordable Care Act, the Bipartisan Budget Act of 2018, the American Recovery and Reinvestment Act, and the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015.
Matt holds an undergraduate degree from the University of Denver—where he also currently serves as an associate professor of public policy—and a Master of Public Policy from The George Washington University.
Authored Content
Proposed updates to the Part D risk adjustment model to further separate MA-PDs and PDPs will change plan payments for certain conditions if finalized.
New analysis finds that just over 40,000 Medicare FFS patients with end-stage renal disease (ESRD) elected to enroll in Medicare Advantage during the 2021 open enrollment period—the first time all ESRD patients had access to an MA plan. This enrollment shift increased the proportion of ESRD patients enrolled in MA from 23% to 30%.
While the premium stabilization program under the IRA limits the growth of the base beneficiary premium, individual plan premiums vary.
IRA policies and growing enrollment in Medicare Advantage could begin to destabilize the standalone PDP and LIS benchmark plan market.
Comments on initial negotiation guidance significantly shaped the revised guidance, underscoring the importance of stakeholder engagement in IRA implementation.
The revised guidance contains significant changes to the initial guidance released in March, but important outstanding questions remain.
Avalere experts discuss Congress’ ongoing consideration of pharmacy benefit manager (PBM) legislation.
Providers and pharmacies are two critical stakeholders that should prepare their own IRA strategies to adequately react to a changing landscape.
Plans preparing MA-PD and PDP bids for Plan Year 2025 should consider how Part D redesign will affect enrollee costs, plan payment, and market dynamics.
The accuracy of the CMS-HCC model differs by beneficiaries’ race and ethnicity.
Avalere’s expert presentations at the AXS23 Summit described IRA drug-pricing policies and the law’s impact on patient access and affordability.
Stakeholders in the drug supply chain should consider operational complexities that will result from variable arrangements for accessing the MFP.
Avalere Policy Edge survey of bipartisan health policy experts suggests that PBM oversight and reform legislation will pass during this Congress.
Continued shifts in Medicare Advantage enrollment introduce new value-based care opportunities for patients with ESRD.
The first Insight in this series explores timing for Medicare negotiation, inflation rebates, and Part D benefit redesign changes and details to be defined.
Join Avalere experts Elizabeth Carpenter and Matt Kazan for a discussion on the 2022 midterm election results and what to watch for future healthcare legislation.
Join us for a live, expert discussion on life sciences industry trends to watch in Q4.
Understanding where federal agencies will make key determinations on details of the IRA’s policies will be crucial for stakeholders seeking to shape implementation and prepare for their impact.
Tune into the second episode in our video series focused on Medicare Advantage. In this segment, Avalere experts and former Center for Medicaid and Medicare (CMS) employees Sean Creighton and Tom Kornfield discuss their thoughts on the best ways for health plans to influence CMS decision making, including timing of engagement and critical messaging elements.
Tune into the first episode in our video series focused on Medicare Advantage. In this segment, Avalere experts and former Centers for Medicare & Medicaid Services (CMS) employees, Sean Creighton and Tom Kornfield, discuss the outlook for Medicare Advantage, factors that will influence growth of the program, and a behind-the-scenes look at CMS policymaking considerations.
Avalere Policy Edge survey of bipartisan Congressional and health policy experts suggests the Build Back Better Act (BBBA) will likely pass in 2022.
As Democrats seek consensus on a "skinny BBBA," concerns over inflation and deficit reduction will place greater emphasis on "pay-for" targets to advance healthcare priorities.
Avalere released a white paper analyzing spending and utilization among Medicare beneficiaries receiving care from independent physician practices and hospital-owned physician practices in Ohio.
In 2022, nearly 4.5 million beneficiaries are in Medicare Advantage (MA) plans offering Special Supplemental Benefits for the Chronically Ill (SSBCI), compared to 1.2 million in 2020, the first year these benefits were available.
Join Avalere’s healthcare policy experts for an analysis of the final rate announcement and a discussion on the future of Medicare Advantage (MA) and potential outcomes for health plans.
Congressional Democrats have indicated interest in a slimmed-down BBBA alternative that could pass the Senate. Pending deadlines and the expiration of ARPA subsidies may create impetus for Democrats to act on legislative health care priorities in 2022.
The first Congressional hearings for user fee reauthorization begin on February 3, 2022, and current legislative authority for UFAs will expire in September 2022.
From policy and regulatory changes to COVID-19 and driving customer engagement, the healthcare environment continues to require healthcare stakeholders to adapt their strategies. How will you stay ahead of the trends impacting your business?
Tune into another episode of Avalere Health Essential Voice. In this segment, Avalere policy expert Matt Kazan discusses what he expects to see from a legislative perspective this fall on Capitol Hill.
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).
As the Centers for Medicare & Medicaid Services (CMS) consider what, if any, changes to propose to Medicare Advantage (MA) through fall rulemaking, stakeholders should consider where the Biden administration’s priorities may differ from the previous administration’s. Topics that may be addressed—either in regulation or via legislation—include health equity, supplemental benefit flexibility, star ratings, payment and risk adjustment, and end-stage renal disease (ESRD).
In his first address to Congress, President Biden signaled that healthcare will continue to be a high priority for his administration, specifically highlighting pandemic response, drug pricing priorities (e.g., Medicare negotiation), and Affordable Care Act (ACA) enhancements.
Join Avalere’s panel of data analytics, market access, and policy experts for a discussion on the potential for federal drug pricing reform in Congress or via administrative action.
A second reconciliation package could include significant drug pricing reforms as a means to pay for permanent coverage expansion and other top priorities.
Tune into another episode in the Avalere Health Essential Voice podcast series focused on COVID-19. In this segment, Richard Ashworth, President and CEO of Tivity Health, joins us to discuss survey findings around COVID-19 and the senior population, with key takeaways related to vaccination acceptance and hesitancy.
The COVID-19 public health emergency, new policy changes, and existing unmet patient needs will pressure the evolving payer, provider, and reimbursement landscape for kidney care in 2021.
New Avalere analysis finds that 3 proposals to redesign the Part D benefit—H.R.19/S.3129, Prescription Drug Price Reduction Act (PDPRA), and Elijah Cummings Lower Drug Costs Now Act (H.R.3)—would increase 2023 mandatory manufacturer discounts by 80%, 81%, and 283%, respectively, with significant variation across therapeutic areas.
Recent regulatory action released in the final days of the Trump administration related to Medicare Advantage (MA) and Part D could significantly impact plan and manufacturer calendar year (CY) 2022 contracting strategies and stakeholder advocacy priorities.
The outcome of Georgia’s runoff election—resulting in a Democratic majority in the Senate—combined with the existing Democratic majority in the House and incoming Biden administration, significantly changes the policy outlook for 2021.
The accelerated changes and increased uncertainties in healthcare brought on by the COVID-19 pandemic will continue into 2021, and its impacts are likely to shape healthcare for years to come. While prevalent uncertainty is a given, the broad outline of a new era is already emerging. More than ever, careful examination of healthcare stakeholder’s business models, policy developments, and data will be essential to arrive at accurate assessments of the future state. Our experts engaged in a live discussion covering critical issues facing healthcare leaders and strategies for clearing the path.
Earlier today, the Trump Administration released long-anticipated drug pricing reforms, including rules related to a Most Favored Nation (MFN) approach for drugs administered by providers in Medicare and rebate reform for the Medicare Part D program. Both rules represent fundamental shifts in our current system and have significant implications for manufacturers, health plans, pharmacies, providers, and patients.
The accelerated changes and increased uncertainties in healthcare brought on by the COVID-19 pandemic will continue into 2021, and its impacts are likely to shape healthcare for years to come. While prevalent uncertainty is a given, the broad outline of a new era is already emerging. More than ever, careful examination of healthcare stakeholder’s business models, policy developments, and data will be essential to arrive at accurate assessments of the future state. Our experts engaged in a live discussion covering critical issues facing healthcare leaders and strategies for clearing the path.
For even deeper coverage, download the 2021 Healthcare Industry Outlook document below.
For even deeper coverage, download the 2021 Healthcare Industry Outlook document below.
Tune into our seventh video of the Avalere Health Essential Voice: Election 2020 series. As election day approaches, our experts share their thoughts on how the COVID surge has changed the campaigns’ closing arguments, the current outlook on a COVID relief package, and how the election results will affect individual stakeholders.
Tune into our seventh episode of the Avalere Health Essential Voice: Election 2020 series. As election day approaches, our experts share their thoughts on how the COVID surge has changed the campaigns’ closing arguments, the current outlook on a COVID relief package, and how the election results will affect individual stakeholders.
Avalere experts discussed how the 2020 election is influencing the future of healthcare.
Tune into our fifth episode of the Avalere Health Essential Voice: 2020 Election series. In this segment, our experts discuss the evolving makeup of the Supreme Court and the outlook on California vs. Texas — the upcoming Supreme Court case regarding the constitutionality of the Affordable Care Act and, in particular, the individual mandate.
Tune into the fifth video of the Avalere Health Essential Voice: 2020 Election series. In this segment, our experts discuss the evolving makeup of the Supreme Court and the outlook on California vs. Texas — the upcoming Supreme Court case regarding the constitutionality of the Affordable Care Act and, in particular, the individual mandate.
With the US Supreme Court set to hear arguments starting November 10 on California v. Texas, and Judge Amy Coney Barrett’s nomination under consideration in the Senate, questions remain regarding the future of the law.
Watch the fourth video in the Avalere Health Essential Voice: 2020 Election series. In this segment, our experts discuss top healthcare issues and platforms from the first Presidential debate, including the Affordable Care Act (ACA), COVID-19, public health, health disparities, and drug-pricing reform.
Tune into our fourth episode of the Avalere Health Essential Voice: 2020 Election series. In this segment, our experts discuss top healthcare issues and platforms from the first Presidential debate, including the Affordable Care Act (ACA), COVID-19, public health, health disparities, and drug-pricing reform.
Avalere analysis finds End Stage Renal Disease (ESRD) spending in Puerto Rico varies substantially, and most spending is related to outpatient dialysis and inpatient services.
Tune into our third episode of the Avalere Health Essential Voice: 2020 Election series. In this segment, our experts discuss candidates’ respective approaches to drug pricing policies, and where there is unexpected overlap.
Tune into our third episode of the Avalere Health Essential Voice: 2020 Election series. In this segment, our experts discuss candidates’ respective approaches to drug pricing policies and where there is unexpected overlap.
Yesterday, the Administration released the awaited “Most Favored Nation” Executive Order (EO), which calls for a model that would cap the price Medicare pays for select Part B and D drugs.
Tune into our second episode of the Avalere Health Essential Voice: 2020 Election series. In this segment, experts from the policy and vaccines teams discuss the healthcare themes heard at the recent political conventions, and differences we can expect to see in the candidates’ healthcare platforms.
Tune into our second episode of the Avalere Health Essential Voice: 2020 Election series. In this segment, experts from the policy and vaccines teams discuss the healthcare themes heard at the recent political conventions, and differences we can expect to see in the candidates’ healthcare platforms.
Under the Medicare Advantage (MA) Star Ratings Program, plans with 4-stars or more receive the greatest benefit from the Quality Bonus Program (QBP) in the form of higher benchmarks and bonus payments.
Surprise and balance billing reform efforts have been a subject of ongoing debate at the federal level.
Tune into our first episode of the Avalere Health Essential Voice: 2020 Election series. In this segment, our experts discuss the healthcare disparity issues at the forefront of the 2020 election and which healthcare topics to watch for at the Democratic National Convention.
In the first episode of the 2020 Election with Avalere series, Avalere experts discuss the healthcare disparity issues at the forefront of the 2020 election and which healthcare topics to watch at the Democratic National Convention.
Avalere’s 2020 Election series started with our experts covering the current state of play in the 2020 election and the role of healthcare between now and November.
Dually eligible beneficiaries in Pennsylvania with end-stage renal disease (ESRD) are more often people of color and have higher costs compared to non-duals, but their utilization patterns are similar.
With the release of the 2021 Medicare Advantage (MA) and Part D Final Rule, the details of the upcoming policy change that allows beneficiaries with end-stage renal disease (ESRD) to enroll in MA are set. Stakeholders need to adapt quickly to be prepared.
Faced with a rapidly evolving healthcare environment, there are a number of important uncertainties that commercial insurers will need to consider when planning for the future
On April 9, Avalere experts came together to discuss the impact of COVID-19 on the health insurance industry.
Tune into the eighth episode of our series of podcasts that focuses on COVID-19. In episode 8, Avalere experts from the Policy practice discuss the impact of COVID-19 pandemic on retail pharmacy and pharmacists.
The kidney care payment and delivery landscape was poised for change in 2020 due to existing policies and market trends. Given the specific risk COVID-19 poses to these patients, the pandemic is creating new challenges and potentially accelerating existing trends in the kidney care space.
As COVID-19 continues to stress the US healthcare system, pharmacists and retail pharmacies may help respond to the pandemic.
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.
Our panel of experts engaged in an in-depth discussion of the rapidly evolving regulatory environment surrounding COVID-19 testing and treatment and the strategic, financial, and operational challenges this disease presents for health insurers.
Tune into the fifth episode of our series that focuses on COVID-19. In episode 5, Avalere experts from the Policy practice discuss how COVID-19 has impacted the healthcare landscape and policy debate.
The growing prevalence and disparities in chronic diseases necessitate that health plans address food insecurity to improve patient outcomes. The combination of increasing need for access to healthy food and changes in the health policy and insurance landscape create opportunities to address food insecurity through a variety of payers.
Avalere analysis finds that average beneficiary out-of-pocket (OOP) spending for 3 commonly used insulin products remains similar throughout the year, ranging from $95 in December to $136 in June and July.
Avalere analysis finds differences in the demographics of patients with End Stage Renal Disease (ESRD) enrolled in Medicare Advantage (MA) compared to ESRD patients in Fee-for-Service (FFS) Medicare
Avalere analysis finds that many CA beneficiaries enrolled in D-SNP look-alike plans may not be able to a transition to a D-SNP.
This month, the Centers for Medicare & Medicaid Services (CMS) proposed changes to Medicare Advantage (MA) through the annual Advance Rate Notice and Proposed Rule. These proposals impact MA in many ways, including changes to quality bonus payments, network adequacy requirements, coverage of End Stage Renal Disease (ESRD), plans targeting dual eligibles, and supplemental benefit offerings. Stakeholders should examine each of these areas closely as they respond to CMS.
CMS is set to release its annual proposed changes to Medicare Advantage (MA) this week. Some of the topics that may be addressed include End-Stage Renal Disease (ESRD), network adequacy requirements, payment to MA plans that offer the hospice benefit, and the MA quality bonus program.
Avalere analysis finds that payment to Medicare Advantage (MA) plans for end-stage renal disease (ESRD) patients in highly populated regions may be significantly below actual patient costs.
A shifting policy landscape and emerging market forces could introduce significant disruption in the kidney care space in the coming years. Understanding the risks and opportunities that these changes may present will be critical for patients, providers, payers, and manufacturers alike.