MOH (US)

CMS informed Medicare Advantage (MA) insurers [HUM, UNH, CVS, ELV, CNC, ALHC, MOH, CLOV] that it is voluntarily recalculating their CY26 Star Ratings, which determine CY27 Quality Bonus Payments (QBP). Under the agency’s approach, released…

CMS’s long-awaited interim final rule implementing the One Big Beautiful Bill’s (OBBB) Medicaid Community Engagement (CE) requirements largely aligns with our expectations that CMS would defer to states on program design and implementation, which we…

Last week’s federal court ruling in favor Clover Health (CLOV) against CMS injects fresh uncertainty into the Medicare Advantage (MA) Star Ratings and quality bonus payment framework [UNH, HUM, ELV, CVS, ALHC, CNC, MOH]. While…

With 1Q26 earnings now largely complete for the major Medicare Advantage (MA) insurers [UNH, HUM, ALHC, CVS, ELV, CNC, MOH], near-term MA policy risks remain less acute, though far from extinguished. Congressional cuts remain unlikely…

A wave of state actions (AR, IA, ID, IN, MO, MT, NC, NE, NH) on Medicaid community engagement requirements (aka work requirements), spanning both accelerated implementation like today’s launch in NE and in some cases,…

As the prospects have risen for another budget reconciliation bill, so has the risk for another legislative round of healthcare spending cuts, pressuring insurers, hospitals and home care and hospice agencies as a partial pay-fors…

With Medicaid insurers [MOH, CNC, ELV] projecting more muted Medicaid enrollment changes for 2026 compared with the sizable attrition during the post-pandemic Medicaid unwinding – and little guidance on what comes next – investors are…

CMS’s negative surprise to Medicare Advantage (MA) insurers [HUM, UNH, ALHC, CVS, ELV, CNC] – which is also likely to spill over into weakness among insurers less or not exposed to this market [MOH, OSCR,…

While UNH’s announcement this morning that it will rebate its expected 2026 ACA profits has drawn the most attention – and may pressure other Obamacare insurers [ELV, CI, HUM, CNC, OSCR, MOH] to make similar…

CMS’s preliminary guidance to states on its interpretation of the One Big Beautiful Bill’s  (OBBB) Medicaid provider tax provisions does not appear to tighten the screws on states, and thereby threaten hospitals [ARDT, CYH, HCA,…