Webinars
Learn from the best in healthcare. We present you with real-time developments and actionable strategies. Register to ask your immediate questions and to access our slides.
The 2016 Elections Impact on Healthcare Policy
With expanded administrative authority and flexibility to advance policy priorities through entities such as CMMI and IPAB, the new administration will shape the future of the Affordable Care Act, potential drug pricing reforms, and potential action on tax and/or entitlements.
Navigating the Exchange Market: Policy Updates and Strategies for Mitigating Risk
Earler this month, the Obama Administration released the proposed Notice of Benefit and Payment Parameters (NBPP) for the 2018 plan year. Meanwhile, the exchange market faces instability. Recent Avalere analysis finds that more than one-third of rating regions may have only one insurance carrier participating on the exchange in 2017.
EPMs: The Newest Bundled Payment Model
CMS released another mandatory bundled payment proposed rule which will significantly expand the scope of hospitals bearing risk for episodes of care nationally.
New Alignments in Data-Driven Care Coordination and Access for Specialty Products
Recently we examined the various models of specialty pharmacy integration/ownership and how they result in different care coordination dynamics and access to drugs. Our findings demonstrate real value and opportunities in linking medical and pharmacy data to better support the patient journey with services and tools.
Performance-Based Risk-Sharing Arrangements: What Are the Views from the Negotiating Table?
Shifting to a value-based purchasing (VBP) system provides opportunities to engage payer and provider customers in unique contracting and reimbursement relationships that may optimize market access.
MACRA: Preparing for a Revolution in Physician Payments
One year after Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) in a landslide, the Department of Health and Human Services is implementing this legislation to transform physician payment.
CJR and Beyond: Excelling in an Era of Mandatory Bundled Payment Models
With the launch of the Comprehensive Care for Joint Replacement (CJR) model on April 1, CMS has ushered in a new phase for payment reform. Under this mandatory program, roughly 800 hospitals across the U.S. will assume financial accountability for the cost of all services provided to Medicare patients during 90-day care episodes for hip and knee replacements.
Focus on Value: Understanding the Impact of Performance Contracting on Market Dynamics
Avalere hosts a series of webinars on “Navigating the New Dynamics of Outcomes Contracting and Risk Sharing Arrangements”. While traditional rebating and discounting terms have been a staple of industry contract negotiations, a new strategic focus is emerging on additional modes through which overall value can be measured for the wave of high-cost drugs now coming to shore.
Patient-Reported Outcomes: Using PROs to Measure Performance in New Payment Models
Achieving a vision of patient-centered healthcare requires multi-stakeholder collaboration each step of the way. As national attention on the use of patient-reported outcomes (PROs) grows, significant progress needs to be made to ensure that they are fairly used for accountability purposes in the context of performance-based payment models.
Tying Payment to Value: Lessons Learned from the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract
By the end of 2016, HHS plans to make 30% of fee-for-service payments through alternative payment models, such as accountable care organizations and bundled payments, and tie 85% of all fee-for-service payments to quality or value. This places increasing urgency on healthcare organizations to make a fundamental shift in their approach to care delivery.
2015 Industry Outlook: Strategic Implications of Healthcare Changes in the New Year
In 2014 the healthcare industry saw fundamental change in how health plans approach the market, provider consolidation in many areas, a focus on quality-based payments, unprecedented growth in consumer liability for the cost of chronic illness, and a slowing in the rise in healthcare costs.