We are delighted to announce that HealthScape Advisors has joined Chartis, one of the nation's leading healthcare advisory firms.  Read the press release.

EXECUTIVE BRIEFING | May 13, 2024

CMS is Driving Towards Greater Integration Between Medicare and Medicaid

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

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EXECUTIVE BRIEFING | May 1, 2024

CMS Revamps MA Agent and Broker Compensation: Implications from the Final Rule

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The Centers for Medicare and Medicaid Services’ (CMS’) recently released final rule finalizes changes to the Medicare Advantage (MA) prescription drug program (MA-PD) for Contract Year 2025 (CY 25). CMS’ stated goal for the final rule is to strengthen consumer…

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Executive Briefing | February 8, 2024

Less is the New More with Medicare Advantage Supplemental Benefits in 2024

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Medicare Advantage Organizations (MAOs) face an inherent tension to grow despite financial constraints on margin. This pressure makes it difficult to invest in competitive benefit design elements that are known to drive growth, including supplemental benefits. Significant financial headwinds including…

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Executive Briefing | January 9, 2024

Four Pressures Shaping Health Plans in 2024

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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…

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Executive Brief | November 28, 2023

Contract Year 2025 Policy and Technical Changes to Medicare Advantage

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CMS recently released its proposed rule for Medicare Advantage Organizations (MAOs) and Part D sponsors for contract year 2025. While the proposed rule outlines meaningful policy and technical changes to the Medicare program (e.g., behavioral health, health equity, agent/broker compensation, D-SNP…

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Executive Brief | November 2, 2023

2024 Star Rating Analysis: The Story Lies Beyond the Outliers

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Introduction The recent publication of 2024 Medicare Advantage (MA) Star ratings confirmed that the regulatory and operating environment for this program will challenge health plans (especially compared to past years) as the Centers for Medicare and Medicaid Services (CMS) shifts…

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Executive Briefing | March 14, 2023

HealthScape Advisors’ Insights on 2023 AEP Performance

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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…

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Executive Briefing | February 14, 2023

Supplemental Benefit Trends 2023

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Studies have previously suggested that MA members are “sticky” and rarely change coverage; however, this behavior may be changing given the proliferation of product options and availability of rich benefits. For example, at the recent JP Morgan Healthcare Conference, Humana…

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Executive Briefing | February 2, 2023

Health Plan Outlook for 2023: Market Trends Become Mainstream

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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…

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Article | August 2022

ACO REACH Model Program Updates – ‘Do Nothing’ is Not a Strategy

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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…

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