Meet
Shelby Harrington
Managing Director
Shelby Harrington, RN, supports clients in navigating the transition to value-based care with a focus on quality of care, clinical and financial outcomes, and patient centeredness.
Shelby works with clients to develop value-based care strategies and then shape the landscape through policy and regulatory levers such as quality measures, value-based payment models, and large-scale implementation of improvement initiatives. She is a nationally recognized expert in federal quality programs and measure development processes, and is a member of the NCQA’s Industry Council. Shelby also drives a focus on patient-centered drug development and value messages through qualitative and mixed-methods research to characterize patient-centric outcomes (e.g., improved mental health, relationships, employment, ability to parent) and patient preferences and priorities for treatment. These strategies have supported product pricing and formulary placement and overcome coverage barriers, such as prior authorization, for client assets.
Before joining Avalere Health, Shelby led clinical product and strategy at Nurx, a direct-to-consumer telemedicine startup. Previously, she served as senior product director for quality and regulatory technology at Premier, Inc., overseeing hospital regulatory products, provider registries, provider MIPS solutions, and value analytics products. Before that, Shelby worked as director of clinical excellence for the Advisory Board Company’s Crimson Population Health software suite, where she led deployment of evidence-based care plans and launched a population health quality reporting solution. Shelby began her career at Carolinas HealthCare System—now Atrium Health—as a staff nurse in orthopedics and trauma care before progressing to leadership roles in quality and patient safety for inpatient acute and inpatient rehabilitation hospitals.
Shelby holds a bachelor’s degree in public policy analysis from the University of North Carolina at Chapel Hill and bachelor’s and master’s degrees in nursing from Virginia Commonwealth University.
Authored Content
Prevention, technology-enabled whole-person care, real-time measurement, simplification, and accelerated innovation were key themes at the recent quality conference.
Rare disease demands a unique playbook: The patient journey is rarely linear, the evidence base is often limited, and “rare” can have different meanings across settings and geographies. The third edition of our annual rare disease eBook explores the unique dynamics of the rare disease landscape and its implications for biotech stakeholders.
Reported plans to reshape the USPSTF align with recent changes to ACIP and may shape the future of preventive care recommendations and access.
Quality is the bedrock of high-value care and should be a critical focus for manufacturers seeking to ensure access, coverage, and widespread adoption of therapies in clinical practice.
Disease registries can provide high-quality data and may serve as an additional resource when developing medical interventions for rare and ultra-rare diseases.
Life sciences companies, payers, and advocates can weigh in on patient-centered value assessments in a new public comment opportunity.
A white paper explores ways in which VBC payment models can benefit from incorporating allied health domains, such as Orthotics and Prosthetics.
Avalere attendees of the National Organization of Rare Disorders (NORD) Breakthrough Summit shared a recap of themes from the conference in MedAd News.
For researchers developing new medicines and therapies, real-world data gives them an understanding of patients’ actual experiences outside of clinical trials.
Avalere assessed quality measurement, quality improvement, and value-based initiatives in rare disease and the opportunity for a cohesive quality strategy.
The second installment of our Health Plan series examines how clinical care will shift in reaction to changes in demographics, technology, and environmental factors.
Innovation models will prioritize improving quality and redefine how quality is measured.
This expert panel will address the challenge of integrating patient perspectives into value assessments, discussing implications for evidence strategy, health equity, caregiver involvement, and downstream impacts on care delivery.
In this installment of our 2024 Trends Influencing Rare Disease series, Avalere experts summarize key learnings for pharmaceutical companies to consider.
Avalere and the Amputee Coalition analyzed claims data to understand the prevalence of limb loss and limb difference and the implications for public policy.
In this installment of our 2024 Trends Influencing Rare Disease series, Avalere experts dive into patient centricity trends in rare disease.
Innovative research methods can be used to measure the total burden of rare disease, including direct medical costs, indirect costs, and overall life impacts.
In this installment of our 2023 Top Trends in HEOR series, Avalere experts dive into Trend #5, patient engagement and centricity in healthcare decision making.
The patient perspective should be incorporated across the care spectrum, including clinical research and drug development, care decisions, outcomes measures, and how value is defined.
The development and launch of rare disease therapies require tailored strategies that account for unique patient journeys and the broader evolving landscape.
Significant investment and attention has been paid to the digital health space in recent years as a promising frontier in improving care for patients. In this video, Avalere experts discuss several solutions, including increased, streamlined stakeholder collaboration, improvements in evidence generation, established value assessment frameworks, and identification of a clear reimbursement pathway that can create a path for more optimal access, uptake, and utilization.
Avalere experts discuss trends and advancements in the kidney disease space, including payment models, digital health interventions, and key considerations for manufacturers.
A significant push towards patient-centered value has occurred in recent years, yet a validated instrument to collect patient-centered data has not been established. The Patient Perspective Value Framework (PPVF) Initiative offers an approach for addressing this missing piece.
The IRA will reduce out-of-pocket drug costs (especially in Medicare Part D), increase the availability of marketplace plans, and expand access to vaccines.
Drug manufacturers can use real-world evidence (RWE) before and after approval to advance product development and adoption.
Telehealth solutions aimed at enhancing quality, cost, and equity require greater investment in evidence generation and clinical practice guideline development.
The Health Systems Transformation Research Coordinating Center aims to change how research is generated, funded, and used to transform health systems in promotion of broader health equity for Medicaid-eligible individuals.
Avalere experts Amanda Napoles and Shelby Harrington share recommendations for shifting to patient-centered value during our 2023 Outlook webinar.
The COVID-19 pandemic has catalyzed the growth of hybrid care delivery models, highlighting the need for clinical guidance and stakeholder agility.
Traditional health technology assessments fall short in accounting for how therapy addresses the total burden of illness experienced by affected individuals.
The end of the public health emergency (PHE) raises policy questions around implications for reimbursement, patient access, and operationalization of telehealth service delivery.
Avalere experts will discuss patient-centric value frameworks, their utility to different stakeholders, and how they can drive the transformation to a patient-centered, equitable health system at the AMCP Nexus 2022 conference.
Global Malnutrition Composite Score Included in Inpatient Prospective Payment System Final Rule
Tune into the second episode in the Avalere Health Essential Voice podcast series focused on the how CMS and Medicare coverage decisions define patient access. In this segment, our experts continue the conversation around national coverage determinations (NCDs)that have coverage with evidence development (CED) requirements, how FDA and CMS’s evidence questions can be complimentary, and the ways in which manufacturer evidence generation plans can address those goals, using the NCD on monoclonal antibodies for Alzheimer's disease as an example.
The final CMS NCD for amyloid beta-targeting monoclonal antibodies for Alzheimer’s Disease establishes a dual pathway to Medicare coverage based on FDA approval and likely creates access and operational challenges for stakeholders.
A nationwide shortage of clinical and non-clinical professionals is straining the healthcare industry. Every part of the health ecosystem is making contingency plans for this ongoing and worsening labor shortage. Solutions range from traditional market approaches of wages and benefits to innovative staffing activities and advocating for policy changes.
Prescription Digital Therapeutics (PDTs) are a growing and unique treatment modality that can provide expanded options for treatment to patients. As the landscape for these treatments develop across multiple therapeutic areas, challenges related to coverage, reimbursement, and access will need to be solved to advance broader adoption and utilization across key stakeholders.
In the recently released Centers for Medicare & Medicaid Services (CMS) proposed rule for the CY 2022 Medicare Physician Fee Schedule, CMS proposed to include an Avalere-submitted malnutrition-focused improvement activity (IA) in the Merit-based Incentive Payment System (MIPS).
Tune into another episode of Avalere Health Essential Voice. In this segment of our Disease Education series, experts from our Center for Healthcare Transformation discuss the burden of malnutrition on our healthcare system and how an Avalere-led quality improvement initiative has helped systems across the country improve malnutrition identification and treatment.
Tune into another episode of Avalere Health Essential Voice. In this segment of our Disease Education series, experts from our Center for Healthcare Transformation discuss the burden of malnutrition on our healthcare system and how an Avalere-led quality improvement initiative has helped systems across the country improve malnutrition identification and treatment.
To better understand key motivations and barriers to using PROs in clinical care, Avalere conducted a literature review, identified existing PRO-PMs in use by payers through our proprietary quality measures database, and conducted interviews with early adopters of PROs. In this paper, we provide our findings and recommendations for next steps.