Health plans are confronting significant pressure to their financial sustainability, including rising costs, new regulations, and increased competition. Rising medical costs remains an ongoing challenge, with medical expenses outpacing projections in 2023 driven by factors such as post-COVID demand, network…

The Centers for Medicare & Medicaid Services (CMS) recently released data that highlights the benefit designs of 2024 Medicare Advantage (MA) plans, inclusive of each MA product’s dental offering. To help our clients understand the results, HealthScape has quickly ingested…

Reprinted with AIS Health permission from the Oct. 19 issue of Radar on Medicare Advantage Leading up to the Oct. 15 start of the Medicare Annual Election Period (AEP), news reports across the U.S. have depicted down-to-the-wire disputes between Medicare…

Leading Market Trends and Challenges from the MLTSS Leadership Summit Managed Long-Term Support Services (MLTSS) continues to be spotlighted in discussions of complex care management, whole person care models, health disparities, and the direct care workforce shortage. Managed Care Organizations…

Market strategies to drive transformation of healthcare delivery and payment towards value are at a cross-roads. In response, health plan VBC strategy success will depend on their ability to develop and deploy specialty VBC models. Industry advancements in value-based care…

In the past few years, the COVID-19 pandemic has dominated our attention, disrupting traditional healthcare delivery and access. During this time, member access to care was largely focused on adapting and responding to the pandemic. Now that the industry has largely reached stabilization…

The Centers for Medicare and Medicaid Services (CMS) recently released data that highlights the benefit designs of 2023 Medicare Advantage (MA) plans, inclusive of each MA product’s dental offering. To help our clients understand the results, HealthScape Advisors has quickly ingested the…

Key Highlights of This Brief: Recent regulatory flexibilities applied to supplemental benefits have significantly expanded the breadth of offerings health plans can explore. Experimentation with initial non-Medicare covered benefits (e.g., dental, vision, hearing) has quickly escalated to “table stakes” offerings…

The Centers for Medicare and Medicaid Services (CMS) Innovation Center recently introduced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model as a redesign of the Global Professional Direct Contracting Model (GPDC). The move represents the…

Medicare Advantage (MA)—the alternative to traditional Medicare which allows seniors to receive Part A and B benefits through private insurance—continues to rise in popularity. As of April 2022, almost half (46%)¹ of all Medicare beneficiaries are enrolled in an MA plan.…