HEALTH SOLUTIONS
Medicare
We detail the Medicare fee-for-service catheter billing anomalies observed during 2025 and discuss the implications for affordable care organizations.
We explore what the Medicare-Medicaid integration opportunity could mean for states as the CMS’s new ACO LEAD model details are released.
Bleeding-related hospitalizations among direct oral anticoagulant users and nonusers in Medicare fee-for-service: Variation in prevalence, burden, and characteristics.
We offer some experience-based insights for medically frail determinations under the new Medicaid work requirements to help states implement an accurate, compliant solution.
The Centers for Medicare and Medicaid Services announced the list of drugs selected for price negotiation for 2028. We broke down the implications.
What should life sciences companies know about risk adjustment for the Medicare, Medicaid, and ACA markets?
Medicare drug price negotiation: With the first cycle where Part B drugs are eligible to be selected, the implications extend far beyond simple price reductions.
We highlight changes in value added and key benefit trends for general enrollment plans in the Medicare Advantage market from 2025 to 2026.
How can healthcare stakeholders use Six Sigma to transform the Medicare Prescription Payment Plan into a widely adopted and trusted benefit?
We review how MA-Part D carriers adjusted their $0-premium PPO offerings in response to margin compression.
A review of the Uniformity Flexibility benefits offered during the contract year 2019 plan year.
Learn why Health Alliance Plan relies on the MedInsight Hospital Evaluation and Comparison System (HECS) tool for hospital contracting.
We dig deep into rich Milliman MedInsight data to bring you insights you won’t find anywhere else, plus updates on the state of regulatory affairs.
Do you know which members are likely to drive costs in the coming years? Learn how you can find out—before it’s too late to do anything about it.