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Looking Ahead to 2026: Preparing for Healthcare’s Next Chapter

Each year, we all like to pause and reflect—not just on where our industry has been, but on where it’s

A Continued Focus on Stars Programming Improves Performance While Lowering Healthcare Costs

Medicare Advantage (MA) plans are feeling the ripple effects of a changing Star Ratings landscape. Fewer plans are earning 4-5

Navigating Medicare Advantage Headwinds: Rebalancing for Adherence

According to Q2 2025 earnings data, Medicare Advantage (MA) is facing notable pressure. Between challenges such as the rollout of

AI, Access and the New Face of Patient Engagement

Following last week’s PQA Convenes panel discussion—where AdhereHealth CEO Kempton Presley joined industry leaders to explore “AI in Practice Today:

The Unique Power of Care Navigators to Improve Health Outcomes in Medicare-Age Adults

Imagine being elderly, juggling prescriptions from three different specialists, and trying to remember whether the blue pill should be taken

Addressing Patient Medication Safety: How to Boost Performance on COB and Poly-ACH Measures

Medication safety has become an urgent priority as Medicare Advantage members increasingly rely on prescription drugs to manage chronic conditions.

Navigating Medicare Advantage SDS Risk Adjustment Changes to Adherence Measures

Beginning in MY 2026, CMS is introducing sociodemographic status (SDS) risk adjustment into the three cornerstone Part D adherence measures:

Maximizing Impact: How “Companion Measures” Strengthen Medication Adherence Strategies 

In the world of Medicare Advantage (MA), medication adherence is the workhorse for strong Star Ratings performance. It’s closely tied

3 Ways PBMs, MCOs and Health Systems Can Differentiate in a Value-Based World

As healthcare continues to shift toward value-based care, Pharmacy Benefit Managers (PBMs), Managed Care Organizations (MCOs) and health systems face

As D-SNP Enrollment Grows, So Does the Need for Smarter, More Integrated Support

With federal rules pushing for better integration of Medicare and Medicaid benefits—and Star Ratings harder to achieve—health plans need more