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Healthcare’s financing evolution: Today’s novel models are learning labs

A single paradigm shift will not define the future of healthcare financing. But significant early trends are in motion as providers, payers, employers, and others experiment together.

Article

Medicare Advantage enrollment indicates a market reset: 2026 report highlights and implications for health systems

The Medicare Advantage market is entering a new phase defined by slower growth, financial retrenchment, and heightened operational discipline. We discuss key takeaways for providers.

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With enrollment closing, Congress debates restoring ACA subsidies and alternative approaches to address affordability

Consumers are already shifting their coverage choices as payers and providers brace for the anticipated financial, access, and political impacts.

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Government reopening brings relief but no agreement on ACA subsidies

The reopening resumes funding for essential healthcare programs, but only through the end of January. Meanwhile, ramping up programs to normal operations will take time.

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Employer-sponsored health insurance premiums keep climbing as ACA subsidy support wanes

As insurance grows increasingly expensive, health systems and health plans will need to prepare for more workers opting out of coverage, delaying care, and presenting with more acute needs.

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Medicare Advantage Star ratings: Flat results, rising challenges

As Medicare Advantage recalibrates, both payers and providers are reassessing how to sustain performance and profitability amid tightening margins and evolving CMS standards.

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A safety net unraveling: How health system and payer collaboration could mitigate the impact of Medicaid cuts

The impending cuts to Medicaid funding will pull at the fabric of US communities, health systems, and payers. But strategic collaboration could help mend—or even prevent—some of the anticipated tears.

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Oz confirmed as Trump Administration finalizes major Medicare Advantage boost

The rate increase comes alongside a revised risk adjustment model. The effects of these changes on the healthcare ecosystem remain to be seen, particularly on access and quality.

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Medicare Advantage market growth slows amid intensified headwinds

Our 2025 Medicare Advantage competitive enrollment report analyzes decelerating growth as the market undergoes a period of correction. We discuss six key trends and action items for health plans.

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As possibility of shutdown looms, latest federal budget proposal needs controversial Medicaid work requirements to balance

While Medicaid work requirements may reduce program costs, they would put 36 million people at risk of losing coverage—with negative impacts on access and population health.