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- “Real Talk” from the Trenches of the Value-Based Payment Movement
- 2016 RADV Market Average Error Rates
- 2017 RADV Preliminary Market Average Error Rates
- 2018 Supplemental Claims Impact
- 2019 Supplemental Claims Impact
- 2020 RADV IVA Results and Insights
- 2020 Supplemental Claims Impact
- 2021 Health Price Transparency: Data Availability and Analysis
- 2021 Medicare Advantage Market Landscape
- 2021 Supplemental Claims Impact
- 2022 Medicare Advantage Summary of Advance Notice Part II
- 2022 Medicare Advantage Summary of Final Rate Notice, Part C and Part D Bid Review Memo
- 2022 RADV Results and Insights
- 2022 Supplemental Claims Impact
- 2023 Physician Fee Schedule Final Rule – Medicare Shared Savings Program Updates
- 2023 Supplemental Claims Impact
- 2024 Medicare Advantage Star Ratings (Tu)Key Takeaways
- 5.0 Star Contracts in the Medicare Advantage Program: Is There an Enrollment “Advantage”?
- A Cut Above the Rest: Summary of 2025 Star Rating Cut Point Changes
- A Deeper Look at the CY2025 Part C FFS Normalization Factor
- A Look at the Impact of COVID-19 on ACA Markets
- ACA HCC Recapture Rate Study
- ACA Unified Rate Review Template (URRT) Market Trends Over Time
- ACO REACH - Direct Contracting Redesigned with Enhanced Focus on Health Equity
- ACO REACH 2023 Landscape
- ACO REACH PY2025 Financial Updates - Could this be the final straw for ACOs?
- ACOs Seeing Success in the Medicare Shared Savings Program in 2020
- American Rescue Plan: Implications for the Individual Market
- An Update on the Retrospective Trend Adjustment in Direct Contracting and ACO REACH
- Analysis on the Impact of the American Rescue Plan Act
- Analyzing Long COVID Using Commercial Claims Data
- Boosting Risk
- California Raises the Bar for Risk-Bearing Entities
- Claims Reserve Margin in the Health Annual Statement: A Review of 2016-2021
- CMMI’s Primary Care First and Direct Contracting Models
- CMS "Capping" ACO Potential: The Need for Capped Regional Risk Scores
- CMS Guidance, Risk Corridors Payments, and MLR Rebates
- CMS HHS-RADV Final Rule
- CMS Proposes Additional Temporary Changes to the Medicare Advantage Star Rating Program
- CMS Proposes Medicare Advantage Changes that Could Jeopardize the Future of Its Value-based Insurance Design Model
- CMS Releases CY 2022 Medicare Physician Fee Schedule
- CMS Releases CY 2023 Medicare Physician Fee Schedule Proposed Rule
- CMS Releases CY 2024 MPFS Proposed Rule
- CMS Releases FY 2023 Hospital IPPS Proposed Rule
- Congress Passes Ban On Surprise Billing
- Connecting the Dots: Potential Implications of the 2022 Direct Contracting Retrospective Trend Adjustment on 2024 MA Benchmark Rates
- Considerations for Benefit Vendors and Providers in Demonstrating Their Value Proposition to Health Plans
- COVID-19 Impact on 2022 Medicare Star Ratings
- COVID-19: Healthcare Cost Considerations for Employers
- Creating Stability in Unstable Times
- Cut to the Point: A Summary of 2024 Star Rating Cut Point Changes
- D-SNPs - What, Why, How
- Defunding CSRs: Challenges and Options
- Demystifying the Retrospective Trend Adjustment in Direct Contracting and ACO REACH
- Did You Make the Cut?: A Summary of 2023 Star Rating Cut Point Changes
- Direct Contracting (ACO REACH) - Observations From The PY2022 Financial Results
- Direct Contracting Geographic Model - Key Questions and Considerations
- Driving Success in the Medicare Shared Savings Program
- Final 2021 and 2022 HHS HCC Risk Adjustment Model Impact Estimates
- Final 2021 and Proposed 2022 HHS HCC Risk Adjustment Model Impact Estimates
- Final 2021 HHS HCC Risk Adjustment Model Impact Estimates - Revised
- Final 2025 HHS HCC Risk Adjustment Model Impact Estimates
- Flexing Their Muscles? Plan Sponsors Weigh in on Medicare Advantage Benefit Flexibility
- From Bid to Trusted Advisor- A Wakely Case Study
- From Coverage Gap to Member Cap: Understanding the New Landscape of Medicare Part D Manufacturer Discounts
- Geographic Direct Contracting Model - a unique and unprecedented opportunity for organizations that can act quickly.
- Global and Professional Direct Contracting Model - Initial Observations from 2021 Financial Results
- Health Equity Adjustment under ACO REACH Program
- High Risk Pools and Risk Adjustment
- High-Risk Pools and the ACA: Funding and Considerations
- Hospital Charge Transparency
- How do Margin Levels Vary in the Health Annual Statement? What Recent History Shows
- ICHRA/QSEHRA Consideration for Pricing Actuaries
- Identifying Medical Spend for Older Adults with Injurious Fall Related Claims- Lessons Learned
- Identifying Medically Frail Individuals – A Kentucky Medicaid Case Study
- Impact of COVID-19 on ACA Markets
- Impact of COVID-19 on ACA Markets - March 2021 Update
- Impact of Draft 2025 Federal Actuarial Value Calculator Updates
- Impact of the Continued Extreme and Uncontrollable Circumstances Policy on MSSP ACOs
- Impacts of the Medicare Prescription Payment Plan
- Implications of the 2023 CAA on Medicare Physician Fee Schedule
- Increased ESRD Beneficiary Enrollment Flexibility Presents Potential Financial Challenge for MA Plans in 2021
- Inflation Reduction Act Review - Summary
- Initial Findings for 2021 Special Enrollment Period
- Is PC Flex Right for Your ACO?
- Issuer Transparency Data: Limitations and Opportunities
- Issues in Part D Bids and Reconciliations that Lead to Overestimation of Cost
- Low Cost Carriers in ACA: Insights from the 2018-2021 Market Experience
- MA Unleashed: CMS Issues Guidance on Newly Established Benefit Design Flexibilty
- MAPD Turns 18
- Medicaid Credibility Analysis
- Medicaid Profitability During the Public Health Emergency
- Medicaid Redetermination Impacts on the Individual Market
- Medicare Advantage Organization Revenue Projection and Management
- Medicare Advantage Star Ratings: 2024 Measurement Year Changes
- Medicare Advantage Startup: Considerations and the Contract Application
- Medicare Buy-in: A High-Level Overview of Considerations
- Medicare Part D 2020: Pharmacy Rebates – So Many Options, So Little Time
- Medicare Part D 2020: Where, Oh Where, Should My Pharmacy Rebates Go?
- Medicare Shared Savings Program Performance Analysis
- Mental Health Parity Updates
- Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses: Highlights from the Proposed Rule
- Navigating Medicare Advantage Risk in a Changing Landscape: Inflation Reduction Act Implications for ACOs
- New 1332 Guidance Gives States More Flexibility
- New Contract Medicare Star Ratings: Why The Sudden Cliff?
- New Data on Enrollment and Uninsured Rates
- Oops, Let's Do It Again: CMS Announces Sweeping Changes to 2025 Quality Bonus Payments
- Opportunities in Dual Eligible Special Needs Plans (D-SNPS)
- Optimizing Contracting and Performance Assessments for Health Plans, Care Management Providers, and Benefit Vendors
- Part D Payment Modernization Model
- Policy Revisions in Response to COVID-19: Temporary Changes to the Medicare Star Rating Program
- Potential Changes Coming to Mental Health Parity Requirements
- Potential for Major Health Policy Changes in 2021
- Potential Impact of Supreme Court Ruling on Part C Benchmarks
- Potential Impacts of the Medicare Drug Discount Card
- Potential PY2024 MA Tailwind - FFS Normalization Factor
- Premium Effects on ACA Enrollment
- Proposed 2021 HHS HCC Risk Adjustment Model Impact Estimates
- Proposed Benchmarking Updates to the Medicare Shared Savings Program
- Proposed Changes to HHS RADV Program
- Proposed MA Risk Adjustment – Don’t Miss Out on the Nuanced Impacts to County Level Benchmark Rates
- Proposed MA Risk Adjustment Model - Good News for Some, Detrimental for Others
- Provider Level Data Analytics that Drive Key Performance Indicators for Direct Contracting Entities
- Reinsurance Funds and Mandate Repeal: Considerations
- Review of CMS Proposed 2018 Risk Adjustment Changes to CSR Plans
- Review of Proposed 2019 Risk Adjustment Changes For State Flexibility
- ROI Analyses for Musculoskeletal Care Management Programs
- Shadow Bundles are Coming Soon to MSSP and ACO REACH
- Short Term Duration Plan: Final Rule
- Site Neutral Payment Reform has the Potential to Significantly Reduce Out-of-Pocket Patient Spend
- SOA Health Meeting Session 5A: Value-Based Payment Arrangements - Past and Future: Session QA Follow-Up
- Social Determinants of Health (SDOH) And Risk Adjustment: Arizona Medicaid Innovations
- States, Medicaid, and Economic Hard Times
- Summary and Analysis of HHS Risk Adjustment Technical Paper on Possible Model Changes
- Summary of 2021 Medicare Advantage and Part D Star Ratings
- Summary of 2022 Medicare Advantage Advance Notice: Upcoming Changes to Star Ratings
- Summary of 2022 Medicare Advantage and Part D Star Ratings
- Summary of 2023 Medicare Advantage and Part D Star Ratings
- Summary of CY2020 Advance Notice and Draft Call Letter
- Summary of CY2021 Proposed Medicare Advantage and Part D Policy & Technical Changes
- Summary of CY2025 Medicare Advantage Advance Notice
- Summary of CY2025 Medicare Advantage Final Rate Announcement
- Summary of Draft CY2025 Part D Redesign Program Instructions
- Summary of Final Rate Notice, Part C, and Part D Bid Review Memo
- Summary of Final Rate Notice, Part C, and Part D Bid Review Memo - CY 2024
- Summary of Provisions of HHS’ Final 2020 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Provisions of HHS’ Proposed 2020 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Provisions of HHS’ Proposed 2021 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Provisions of HHS’ Final 2021 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Provisions of HHS’ Final 2022 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Provisions of HHS’ Proposed 2019 Notice of Benefit and Payment Parameters
- Summary of Provisions of HHS’ Proposed 2022 Notice of Benefit and Payment Parameters
- Summary of Provisions of HHS’ Proposed 2023 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Provisions of HHS’ Proposed 2024 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Provisions of HHS’ Proposed 2025 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of Select Provisions of HHS’ Final 2022 Notice of Benefit and Payment Parameters and Other Key Regulations
- Summary of the Contract Year 2022 Medicare Advantage and Part D Final Rule: Star Ratings Changes
- The Basics of Evaluating PBM Contracts
- The End of Medicaid Continuous Coverage: Programmatic and Rate Setting Considerations
- The Family Glitch and Changes to Premium Tax Credit Eligibility
- The Hidden Driver of Prescription Drug Costs: New Drug Pricing
- The Impact of Social Risk Factors on Medicare Star Rating Performance: Differentiation in HEDIS® and Medication Adherence Performance
- The Importance of Care Management and Quantifying Savings
- The Return of POS Rebates
- Understanding Your ACO's Benchmark
- Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond Rule
- Vision for the Future of CMMI Programs
- Wakely 2018 Preliminary HHS RADV Study
- Wakely 2019 RADV IVA Results & Insights
- Wakely 2023 Final HHS-HCC Model Impact
- Wakely 2023 Proposed HHS-HCC Model Impact
- Wakely 2024 Final HHS-HCC Model Impact
- Wakely Consulting Group, an HMA Company, and Morgan State University announce new actuarial science scholarship opportunity
- Wakely Crafts Oregon's Newly Approved State Innovation Waiver
- Wakely Hospice VBID Part 1: New Option for Medicare Advantage Plans in CY2021
- Wakely Hospice VBID Part 2: Preliminary Capitation Rates for CY2021
- Wakely Medicare Repricing Analysis Tool (WMRAT): Frequently Asked Questions
- Wakely Risk Insight for the Medicare Shared Savings Program: Performance Year 2021 Results
- Wakely Risk Insight for the Medicare Shared Savings Program: Performance Year 2022 Results
- Wakely Summary of 2023 MA Advance Notice
- Wakely Summary of 2024 MA Advance Notice
- Wakely Summary of CY2021 Advance Notice and Related Memos
- Wakely Summary of the 2020 Medicaid and (CHIP) Managed Care Final Rule
- Wakely Summary of the 2021 Final Rate Notice and Part C Bid Review Memo
- Wakely Supports SOA's COVID-19 Healthcare Cost Modeling Project
- Washington Releases Wakely Report on Market Stabilization Policies
- Week in Washington 02/15/2024
- Week in Washington 02/22/2024
- Week in Washington 02/29/2024
- Week in Washington 03/07/2024
- Week in Washington 03/14/2024
- Week in Washington 03/21/2024
- Week in Washington 04/03/2024
- Week in Washington 04/18/2024
- Week in Washington 04/25/24
- Week in Washington 05/02/24
- Week in Washington 05/09/24
- Week in Washington 05/16/24
- Week in Washington 05/23/24
- Week in Washington 05/30/24
- Week in Washington 06/05/24
- Week in Washington 06/13/24
- Week in Washington 06/20/24
- Week in Washington 06/27/24
- Week in Washington 07/11/24
- Week in Washington 07/18/24
- Week in Washington 07/25/24
- Week in Washington 08/01/24
- Week in Washington 08/08/24
- Week in Washington 08/15/24
- Week in Washington 08/22/24
- Week in Washington 08/29/24
- Week in Washington 09/05/24
- Week in Washington 09/12/24
- Week in Washington 09/26/24
- What Drives Medicare Advantage Sales?
- Why Insulin Is So Expensive For Some and Not For Others
- WMACAT Benefit Spotlight: Over-the-Counter Offerings
- WMACAT Benefit Spotlight: Social Needs Benefits
- Written in the Stars: Proposed Changes to the Medicare Star Rating Program in the 2024 Contract Year Policy and Technical Rule
Wakely Wire
- August 1, 2024
- August 15, 2024
- August 22, 2024
- August 30, 2024
- August 8, 2024
- July 11, 2024
- July 18, 2024
- July 25, 2024
- June 13, 2024
- June 20, 2024
- June 27, 2024
- June 6, 2024
- September 13, 2024
- September 5, 2024
