Description: Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will Republican health care reform look like?

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: Discussion of recent laws and regulatory changes that have provided Medicare Advantage plans greater flexibility in benefit offerings and plan designs.

Description: Strategies to position Medicare Advantage plans for success during August resubmission.

Description: This article examines the concept of Actuarial Value, especially as it applies to the Medicare plan of benefits. It discusses the cost-sharing responsibility of Medicare beneficiaries and the means by which they mitigate this risk.

Description: Article describes how Medicare Medical Savings Plans work and why they would be attractive option for insurance companies.

Description: The article explores how deeply the Affordable Care Act reduced the Medicare Advantage benchmark payment rates and quantifies how much of that reduction Medicare Advantage Organizations earned back through quality bonuses.