Avalere

Top 3 factors in biosimilar coverageAn Avalere study has interesting findings about payer acceptance of biosimilars.
Why there’s an uptick in outcomes-based contractsOperational issues aside, outcomes-based contracts can offer a two-fold benefit for managed care executives.
Better outcomes for CF patients in monitoring programStudy examines the effectiveness of the Walgreens Connected Care CF program compared to a matched sample of control patients.
New agreement supports value-based pharma contractingIndustry experts are using their proprietary data/analysis to help structure contracts between pharmaceutical companies and plans.
Opinion: 4 ways to improve ACA risk-adjustment modelThe ACA risk-adjustment model applies to plans sold in the individual and small group commercial market, including plans sold through exchange marketplaces. Here are four main limitations.
Proposed Medicare Part B rule would cut payments for some drugsNew analysis finds proposed Medicare payment changes for physician-administered drugs would reduce reimbursement for those that cost more than $480 per day in 2016. Seven of the 10 drugs that constitute the largest reduction in reimbursement are used to treat cancer.
Pharmacists critical to success in 5 value-based modelsAt AMCP 2016, presenters identified five types of alternative payment models, and shared why pharmacists play a key role.
Don’t underrate power of provider-sponsored MA plansNearly 60% of new MA plans are sponsored by providers, according to new Avalere analysis.
New enrollees in healthcare exchanges to pay more of drug costsThe newly enrolled individuals to the healthcare exchanges will be faced with higher out-of-pocket costs for their medications than those who receive insurance through their employers, according to an analysis by Avalere Health of more than 600 health plans in the exchanges.