The Centers for Medicare & Medicaid Services (CMS) recently released a final rule with changes to the Medicare Advantage (MA) and prescription drug program (MA-PD) for Contract Year 2025 (CY2025). CMS’ stated goal for the final rule is to strengthen…

The Centers for Medicare & Medicaid Services (CMS) recently released the Final Rate Announcement for Calendar Year (CY) 2025. The announcement finalized a payment increase of 3.7% over CY 2024, which (as we previously reported) represents no significant change from…

THE PRESSURE IS ON TO PROTECT EXISTING ENROLLMENT WHILE DEMONSTRATING BETTER VALUE FOR BENEFICIARIES IN MEDICARE ADVANTAGE PLANS. The Centers for Medicare & Medicaid Services (CMS) released the 2025 Advance Notice on January 31, 2024, prompting Medicare Advantage organizations (MAOs)…

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…

As Medicare Advantage Organizations (MAOs) get ready for the upcoming Annual Enrollment Period (AEP), they should proactively prepare for one of the most competitive marketing seasons to date. The cumulative impact from changes in payment rates; regulatory pressure on Third…

This brief builds upon last year’s analysis of Medicare’s Annual Enrollment Period (AEP) and highlights results from the most recent enrollment data available1 from the Centers for Medicare and Medicaid Services (CMS) that accounts for 2023 AEP. Where helpful, we’ll compare…

There is no shortage of challenges and opportunities for health plans in their strategic planning efforts. Earlier this year, we released our Executive Brief, Health Plan Outlook for 2023: Market Trends Become Mainstream to summarize our thoughts on the five…

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…