Avalere

Medicare Advantage vs. specialized Medicare Advantage plans: Outcome effectsAvalere Health analysis has intriguing results about beneficiaries enrolled in diabetes-focused chronic condition special needs plans.
Payments to specialists could yo-yo under MIPSAvalere conducted an analysis to assess the effect of MIPS. Here are the surprising results.
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.