Bridging Silos: How Quality and Risk Adjustment Teams Can Drive Shared Outcomes in Medicare Advantage In the evolving Medicare Advantage landscape, plans are under unprecedented pressure to do more with less. They must demonstrate superior clinical outcomes, deliver exceptional member experiences, and maintain precise, compliant documentation all while navigating complex regulatory changes. Yet, despite shared goals, […]
On November 28 2025, the proposed rule for Contract Year 2027 Medicare Advantage and Part D was published in the Federal Register. The rule addresses several areas of the Medicare Advantage program, including Star Ratings, Part D benefits, dual eligible alignment, marketing requirements, and long standing operational and governance policies. Rather than introducing a single […]
The federal government’s recent 43-day shutdown impacted many facets of everyday life in the United States, including Americans’ health, wellbeing, and access to care. One increasingly vital (yet uniquely vulnerable) component of our healthcare delivery system was adversely affected during the shutdown, yet it received little attention: telehealth. Since the beginning of the COVID pandemic […]
