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

| October 10, 2024

Early analysis: How health plans fared in the 2025 Medicare Advantage star ratings

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Star ratings are critical to Medicare Advantage plans, given the financial and strategic implications. The Centers for Medicare & Medicaid Services (CMS) today publicly released the 2025 star ratings data for all contracts. While health plans have been able to…

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Article | July 3, 2024

CMS Sets New Standards for SSBCI and Supplemental Benefits Across Medicare Advantage Plans

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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…

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Article | July 2, 2024

Seeing the Bigger Picture: How Payers and Providers Can Find Common Ground in Medicare Advantage

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A growing number of disputes have arisen between health systems and Medicare Advantage (MA) plans, with 15 health systems finalizing terminations so far this year. Some have resulted in terminating a single plan’s MA contract, while others have terminated the…

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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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