Medicare Advantage Premiums Expected to Fall More Than 16% in 2027
Medicare Advantage premiums are projected to fall more than 16% in 2027 as CMS reports stable plan availability and modest changes in Medicare Part D costs.
Value-Based Payment News
More Health Plans Earn Top Marks as Medicaid Quality Measures Improve
NCQA’s 2026 Health Plan Ratings show a 64% increase in 5-star plans, along with widespread quality improvements among Medicaid, Medicare Advantage and commercial health plans.
Indiana Launches $68 Billion Medicaid Managed Care Procurement
Indiana is launching a $68 billion Medicaid managed care procurement covering four programs and nearly 1.5 million beneficiaries as the state looks to control rising costs and improve care.
States Move to Regulate AI in Mental Health Care as Vermont and California Push for Stronger Safeguards
Vermont and California are advancing legislation that would limit the use of AI in mental health treatment, requiring greater clinician oversight and stronger patient protections.
States Expand Home-and Community-Based Services to Help More Medicaid Beneficiaries Age at Home
A new analysis finds states are expanding home- and community-based services through Medicaid, but workforce shortages, waitlists, and funding pressures continue to challenge access.
Pennsylvania Invests in Housing Pilot to Improve Health Outcomes for Medicaid Recipients
Pennsylvania is investing $1 million in a Medicaid housing pilot designed to improve health outcomes, reduce hospital use, and address housing instability among vulnerable residents.
Study Highlights Broader Economic Impact of Food Insecurity Beyond Health Care Costs
A new study finds food insecurity is linked to higher emergency department spending, lower income, and greater job instability, highlighting opportunities for managed care interventions.
CMS Proposes Medicare Home Health Payment Increase and Expanded Fraud Prevention Measures for 2027
CMS has proposed a 2.4% Medicare home health payment increase for 2027 while introducing new fraud prevention measures and updates to the Home Health Prospective Payment System.
Federal Watchdog Finds Widespread Errors in Medicaid Maternal Health Provider Networks
New federal reports found significant inaccuracies in Medicaid managed care provider directories and network lists, raising concerns about access to maternal health services.
Medicaid Managed Care Now Represents More Than Half of Program Spending
CMS has released new Medicaid eligibility rules requiring certain adults to meet work, education, or community engagement standards to maintain coverage beginning in 2027.