Author: Avalon Health Economics LLC

Avalon Health Economics is happy to announce the addition of two new consultants to our panel. Jeff Kamil, MD, joins us in the area of U.S. market access and reimbursement. Jeff worked with John Schneider, Avalon’s CEO, several years ago when John was Director of Research at the California Association of Health Plans. Dr. Kamil...

During the health reform discussions leading up to the passage of the Affordable Care Act (“ACA”), there was a lot of talk about the costs of health care services in the U.S. Some argued that the legislation did not go far enough in controlling the underlying upward trends in health care costs, while others argued...

Women make about 80% of the health-care decisions for their families, utilize more health care than men, and are the more likely to be the care givers when a family member becomes sick. Females of all ages accounted for 60% of all expenses incurred at doctors’ offices in 2004. According to the Bureau of Labor...

During the recent debates over the Affordable Care Act (“ACA,” or Obamacare) a commonly raised issue was that U.S. health care does not offer much in the way of “value for money.” The argument, generally, is that we spend a lot more in the U.S. relative to comparable countries but in turn receive poor quality...

Tobacco product litter is one of the most ubiquitous forms of litter, accumulating in increasingly large numbers on streets, highways, sidewalks, beaches, storm water drains, waste treatment plants, parks and other public places. Tobacco product litter (“TPL”) is not simply unattractive; it has been shown to be toxic and costly to clean up. More than...

The health care landscape in the U.S. has been changing rapidly in the past 20 years, a phase of evolution that began with the reluctance of private employers to continue to fund double-digit growth in employee health care costs, thereby creating incentives for third-party payers to develop “managed” insurance products. The next phase of those...

A large proportion of our nation’s health care infrastructure is located in urban markets with declining population. For example, according to the U.S. Census, cities with the largest population decline in recent years include New Orleans, Detroit, Cleveland, Pittsburgh, Toledo, and Buffalo. These very same cities, however, are home to some of the most reputable...

In most markets and in most industries, the prices paid by consumers (or businesses, in the case of business-to-business transactions), are not randomly made up by sellers. To be sure, in less competitive markets, where information is “fuzzy” or sellers have monopolistic power, a seller might be able to name a price and get it....

In the United States, a variety of “usual, customary and reasonable” (UCR) databases are used by health care entities to benchmark their fees (in the case of health care providers) and to create prospectively determined fee schedules (in the case of health care payers). Both of these exercises have essentially the same objective: to assign...