Consequences of new MA and ACA Marketplace regulations
Nick and Shawn discuss regulatory changes coming from CMS for the 2027 regulatory season.
One payer argues for more provider risk amid record high hospital volumes: Q&A
In January, two parts of Highmark Health — Allegheny Health Network (the provider) and Highmark (the insurer) — implemented a risk-based payment model for all of Highmark’s commercially insured groups and Medicare Advantage (MA) populations, as well as many of its Affordable Care Act marketplace plans. Bruce Meyer, MD, executive vice president and Western Pennsylvania…