May 4, 2026

The asthma treatment landscape is continually evolving, bringing new options to the millions of individuals affected by this chronic condition. As novel treatments, such as new triple-therapy inhalers, prepare to enter the market, payers are faced with critical evaluation challenges.

March 4, 2026

CMS is adding four new or updated measures for the 2027 Star Ratings. The Colorectal Cancer Screening measure is being replaced by a respecified version and will be treated as a new measure.

March 4, 2026

CMS updated the Medicare Adjustment (MA) risk adjustment model using more recent underlying Fee-For-Service (FFS) data (2023 diagnoses to predict 2024 costs, vs. 2018 diagnoses predicting 2019 costs), leading to significant changes in some coefficients and other model parameters. 

March 4, 2026

The headline number in the Advance Notice is the Effective Growth Rate and resulting Expected Average Change in MA plan payment.

March 4, 2026

Compared to the Part C rate discussion, the “new” Part D content in the CY 2027 Advance Notice is mostly (1) annual parameter updates and (2) CMS reiterating IRA-driven benefit rules that remain in force.

February 12, 2026

The Advance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Advance Notice) was recently released.

September 10, 2025

President Trump introduced the concept of a copper plan as a solution to healthcare affordability. But is it a solution? Yes, copper premiums will be lower than what is currently offered...

August 4, 2025

Designing health benefits as if they were one-size-fits-all is a bit like issuing steel-toed boots to accountants or medical scrubs to long-haul truckers—it sounds equitable until you look at the bill.

July 11, 2025

The U.S. healthcare system, marked by extraordinary technological capability and deeply rooted inequities, has reached a critical inflection point.