Medicare Advantage (MA) plans continue to face mounting pressure to achieve high Star Ratings, comply with evolving CMS regulations, and deliver equitable, high-quality care. The 2025 Star Ratings averaged just 3.74 (weighted by enrollment), leaving many plans short of their quality and revenue goals. With ~$16 billion in quality bonuses on the line, performance in… Continue reading The New Road to Five Stars: Integrated Care Management for 2026 Star Ratings and Beyond
Health plans operate in a complex landscape where balancing quality care with financial sustainability is critical. Achieving a strong return on investment (ROI) requires a strategic focus on improving efficiencies and implementing cost avoidance measures. This blog explores how health plans can optimize operations, reduce waste, and drive better outcomes for members and stakeholders by… Continue reading Maximizing ROI for Health Plans: Improved Efficiencies and Cost Avoidance
Medicare Advantage (MA) enrollment now tops 34 million beneficiaries, and that number is still growing. But while MA expansion signals success, it also amplifies the complexity and cost of delivering care. Health plans today face a convergence of pressures: Star Ratings are slipping: The average rating fell to 3.92 for 2025, with fewer 4+ Star… Continue reading Built to Scale: How Medicare Advantage Plans Can Grow Without Breaking Their Operations
