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)…

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…

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…

In late February 2022, HealthScape published an initial review of Annual Enrollment Period (AEP) results, noting material changes to Medicare Advantage (MA) membership from December 2021 to January 2022 (when AEP enrollments went into effect) across nearly 300 carriers, including…

This brief details HealthScape Advisors’ first look at Medicare Advantage (MA) 2022 Annual Enrollment Period (AEP) results. As additional enrollment data becomes available from the Centers for Medicare and Medicaid Services (CMS), we will update this brief with any significant…

“We’re going to have an interesting discussion in the next 5 to 10 years because Medicare Advantage has always been a smaller portion of Medicare and Medicare fee-for-service has dominated. Well, that’s changing now.” – Alex Azar, Health and Human…

Health systems are well-attuned to the potential pitfalls of launching a provider-sponsored health plan (PSP) without the right mix of expertise, capabilities and capital. Health plans, on the other hand, are actively seeking partners that can deliver tight network alignment,…

HealthScape Advisors partnered with the Health Plan Alliance and several health plan clients to investigate drivers of success under value-based payment models. As part of this effort, HealthScape engaged 30+ health plans using both an online survey and executive interviews…