Insurance & Payer Strategy
Expert articles and analysis related to insurance & payer strategy.
AI Summary — Last 30 Days
Synthesis:
CMS under the Trump administration has enacted significant changes to Medicare Advantage (MA), including finalized 2027 MA and Part D rules and updated Star Ratings methodology, signaling a continued focus on aligning financial incentives with quality outcomes and digital modernization CMS finalizes MA star ratings changes. The rapid growth in MA Special Needs Plan (SNP) enrollment—now exceeding 8.2 million, up 23% in two years—requires providers assuming MA risk to reexamine contract assumptions and population health strategies MA Enrollment, the SNP Acceleration, and What They Mean for Providers Taking MA Risk. Parallel to these developments, payers are accelerating the shift to digital quality measurement (dQM) and seeking greater scale and data capabilities before entering new value-based arrangements in behavioral health and population health management, sharpening tensions around operational complexity and readiness in risk contracts.
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