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Medicare Policy

Expert articles and analysis related to medicare policy.

89 articles‱Last 24 Hours

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CMS’s 2027 Medicare Advantage Star Ratings are the main Medicare policy development, with about 71% of MA-PD enrollees in plans rated 4 stars or higher—an important signal for MA revenue, quality bonus payments, benefit design, and provider-facing VBC contracts tied to Star performance (Fierce Healthcare). At the same time, CMS data show Medicare readmission penalties rising, with roughly 80% of hospitals facing payment reductions under the Hospital Readmissions Reduction Program, increasing pressure on health systems and ACO partners to tighten post-acute transitions, medication reconciliation, and chronic disease management ([Healthcare Dive](https://

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CMS has additional guidance on Medicaid work requirement exemptions

Figuring out who’s too “medically frail” for work requirements has been a major challenge.

Healthcare BrewOct 8, 2026
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Little room for stakeholder consensus among potential Medicare Advantage reforms

Little room for stakeholder consensus among potential Medicare Advantage reforms  Fierce Healthcare

Fierce HealthcareOct 8, 2026
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What Colorado’s Move To Terminate A Home Care Provider Signals For Medicaid Enforcement

Home Health Care NewsOct 8, 2026
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Week in Washington 10/08/26

Medicare Lawsuits – Several major legal developments this week could impact Medicare. New Transparency Requirements – The federal government finalized changes to the Transparency in Coverage (TiC) reg...

WakelyOct 8, 2026
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New York moves to exempt Bronx from Medicaid work rules

New York moves to exempt Bronx from Medicaid work rules  Becker's Payer Issues

Becker's Payer IssuesOct 8, 2026
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The Blind Spot in Medicare Advantage: How Cut Point Shifts Can Kill 4-Star Ratings

The Blind Spot in Medicare Advantage: How Cut Point Shifts Can Kill 4-Star Ratings  Innovaccer

InnovaccerOct 8, 2026
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Medicare penalizes more hospitals for readmissions

About 80% of hospitals are having their Medicare payments shaved down over high readmission rates this fiscal year, compared with 78% the year prior, according to new CMS data. It continues a worrying...

Healthcare DiveOct 8, 2026
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Medicaid Enrollment by Congressional District and Eligibility Group

From newsletter: Mapping ACA Marketplace and Medicaid Enrollment by Congressional District Mapping ACA Marketplace and Medicaid Enrollment by Congressional District Recent Marketplace and Medicaid c...

Newsletter: KFFOct 8, 2026
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Charting A Path Forward For Medicare Advantage: Expert Consensus On Policy Priorities And Trade-Offs

Charting A Path Forward For Medicare Advantage: Expert Consensus On Policy Priorities And Trade-Offs  RAND.org

RAND Health CareOct 8, 2026
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Coverage and paymentPDP instability accelerates in 2027 as plan options shrink and premiums riseinThought leadershipbyKylie Stengel, Robin Duddy-Tenbrunsel, Kirsten Stryker Blasch, Amanda Tripp, Yiwen HeSep 30, 2026

Coverage and payment

AvalereOct 8, 2026