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Applying machine learning techniques to identify undiagnosed patients with exocrine pancreatic insufficiency14 February 2019 - By Feng Han and Jaime Vora and Jeffrey Gomberg and Monica Son and Motoharu Dei and Nikhil Khandelwal and Bruce S. Pyenson and Maggie Alston - Article

This study develops a machine learning model that identifies patients in a commercial medical claims database who likely have exocrine pancreatic insufficiency but are underdiagnosed.

Changing the rebate game: A primer on the HHS proposed rule to shift drug rebates to POS08 February 2019 - By Maggie Alston and Carol Bazell and David R. Mike - Article
This paper discusses the implications of recently proposed rebate regulation to various Medicare Part D program stakeholders.Breaking through the hype of real-world evidence17 January 2019 - By Maggie Alston and Carol Bazell and Christine Ferro - Article

This paper discusses the expanding use of real-world evidence in healthcare decision-making, as well as the importance of clean and reliable data, robust disease identification algorithms, consistent patient attribution methodologies, and relevant outcomes metrics that can be generated from reliably reported data.

Pharma APMs: A learning curve awaits you, pharma02 October 2018 - By Maggie Alston and Bruce S. Pyenson - Article

There are some valuable lessons for pharmaceutical manufacturers in provider alternative payment models (APMs), but whether pharmaceutical APMs succeed or fail will depend on finding solutions to operational and logistical challenges—some of which are unique to the pharmaceutical industry.

Alternative payment model financial settlements: Preparing for and learning from the process17 September 2018 - By Christine Ferro and Maggie Alston and Pamela M. Pelizzari - Article

This paper focuses on alternative payment model reimbursement methodologies through the lens of the Centers for Medicare and Medicaid Services Oncology Care Model as an illustrative case study.

Pharma APMs: Can the industry learn to play well with others?05 September 2018 - By Maggie Alston and Bruce S. Pyenson - Article

The dynamics of alternative payment models suggest a potential win for insurers, pharmaceutical manufacturers, and patients through an emphasis on reducing cost and improving outcomes.

A primer on prescription drug rebates: Insights into why rebates are a target for reducing prices21 May 2018 - By Gabriela Dieguez and Maggie Alston and Samantha Tomicki - Article

This article explains the finances associated with pharmaceutical manufacturer rebates and their impact on health insurer coverage decisions.

Addressing challenges in the transition to value-based care and alternative payment models: A case study in the Oncology Care Model11 December 2017 - By Maggie Alston and Christine Ferro and Pamela M. Pelizzari - Article

This paper highlights the key aspects of alternative payment model payment methodologies and uses the Centers for Medicare and Medicaid Services Oncology Care Model as a case study to illustrate these concepts.

The differences are in the details: Considerations for comparing 30-day unplanned readmission rates17 October 2017 - By Maggie Alston and Michele M. Berrios - Article

This article identifies key elements that should be considered when evaluating readmission rates across populations or when comparing readmission rates with different methodologies.

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