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Last year, we wrote about the transparency in coverage rule issued by the Centers for Medicare and Medicaid Services (CMS). CMS required most health plans to release machine-readable files of [...]

With Medicare Advantage’s annual enrollment period in full swing, many health plans are likely learning about the effectiveness of their 2023 Medicare Advantage growth strategies. A lack of [...]

Where COVID dominated headlines in 2020 and 2021, inflation has been omnipresent in 2022. Which begs the question: Has inflation impacted health insurance premiums in 2023 in the Affordable Care [...]

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) published their Medicare Advantage Star Ratings for 2023 plans. Here’s a breakdown of the Medicare Advantage Star [...]

Medicare Advantage enables eligible beneficiaries to access Medicare benefits through a private sector health insurer. It’s seen consistent growth in the past decade and should surpass [...]

In August of 2022, Wisconsin’s Office of the Commissioner of Insurance (OCI) released a market analysis conducted by BerryDunn of the state’s individual health insurance marketplace. [...]

ACA Expansion Back in 2017, the Affordable Care Act (ACA) exchange marketplace seemed to be dying. Insurers were leaving state marketplaces – as many as 20% of enrollees only had access to [...]

Calculating Medicaid capitation payments can be a complex process incorporating several factors. Age, health conditions, geography, provider network, gender, and more can play a role in [...]

Last year, an advertisement featuring NFL legend Joe Namath gained attention in Medicare Advantage circles because of some potentially misleading claims. Though the Centers for Medicare and [...]

It’s likely that if you visit a health insurer’s website, it features happy, smiling members. Most insurers focus on delivering a great member experience to attract and retain [...]