With growing fiscal pressures and new legislative proposals on the table, Medicaid Plans are facing unprecedented demands to operate more efficiently—without compromising member outcomes or burning out their teams. Recent proposals from the House and the administration signal a shift toward deeper Medicaid reform, tighter federal spending, and increased state accountability. The question for many… Continue reading Navigating Medicaid Cuts: How Health Plans Can Do More with Less
In January 2024, the Centers for Medicare & Medicaid Services (CMS) finalized sweeping new rules aimed at improving the prior authorization process. These changes, set to take effect starting in 2026, will require most health plans to fundamentally rethink how they manage authorizations, interoperability, and member communication. For health plans—including Medicaid managed care organizations (MCOs),… Continue reading Navigating the CMS Prior Authorization Final Rule: What Health Plans Need to Know
The Medicare Advantage (MA) landscape is evolving rapidly, carrying significant implications for providers, payers, and beneficiaries alike. In a recent webinar titled The Future of Medicare Advantage in the Trump Transition – Will AI Help Pave the Way?, InfoMC Board Member and renowned population health expert Dr. David Nash joined fellow industry leaders from the… Continue reading The Future of Medicare Advantage: Finding the True North with AI and Innovation
