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…

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…

Healthcare payers are navigating through an evolving market landscape. Macroeconomic forces including the conclusion of the COVID-19 public health emergency, rising healthcare costs attributed to inflation, and the ongoing trend in provider consolidation, all contribute to a market of uncertainty.…

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…

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…

INTRODUCTION Driven by the moral imperative to address health disparities and objectives to improve health outcomes, many healthcare organizations have committed to achieving health equity. However, to create sustainable change, organizations must prove the return on investment (ROI) to build…

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)…

February 29, 2024 (Chicago, IL)—Chartis, a comprehensive healthcare advisory firm, today announced Tej Shah and Dan Delaney will lead HealthScape Advisors, A Chartis Company. Chicago-based HealthScape Advisors (HealthScape) helps payers across all segments, including Commercial, Medicare, Medicaid, ACA, Federal, and…

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…