Wakely Wire
July 30, 2026
New Insights
Whitepapers, briefs, press releases and more
The Digital Quality Future Is Now on the Calendar: ACOs Should Not Wait to Prepare
CMS Digital Quality Measurement Timeline (2027–2030): What ACOs Need to Know About FHIR-Based Quality Reporting CMS Has Put a Timeline on Digital Quality Measurement For the first time, CMS has outlined a potential roadmap for transitioning Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) to Fast Healthcare Interoperability Resources (FHIR)-based digital quality measurement (dQM). ... Continue reading
Emerging 2026 ACA Data: Enrollment Drops 12% as Relative Risk Rises 6.3%
New data show a smaller, higher-risk ACA individual market emerging after enhanced premium tax credits expired. In Wakely’s new white paper, 2026 Individual Market Risk Pool Considerations: Emerging Data on Marketplace Post Expiration of Enhanced Subsidies, early 2026 data indicate that Affordable Care Act (ACA) individual market enrollment declined 12.0% while normalized relative risk increased ... Continue reading
What Medicare Data Reveals About Oncology Spending Trends, Innovation, and Cost Forecasting
New Wakely analysis of seven years of Medicare claims data (2018–2024) shows oncology spending is shaped by therapeutic innovation, adoption cycles, biosimilars, and benefit channel dynamics—not price inflation alone. The paper introduces a new framework for forecasting oncology trend: Oncology Trend = Price + Adoption + Duration + Benefit Channel + Replacement This framework suggests ... Continue reading
Newsworthy Findings
Medicare Part D 2027 National Average Monthly Bid Amount Information
On July 28, 2026, the Centers for Medicare & Medicaid Services (CMS) released preliminary technical Medicare Part D bid information for contract year (CY) 2027 to help Part D plan sponsors finalize their Part D and Medicare Advantage (MA) offerings and prepare for Medicare Open Enrollment.
‘Back On Track’: Centene Swings To More Than $1B In Profit In Q2
Centene handily beat Wall Street’s expectations in the second quarter, as higher revenue from premiums and rate hikes for the managed care company’s plans shielded its bottom line from elevated medical costs.
Humana To Exit More Medicare Advantage Plans In 2027
The insurer is laser-focused on reaching margin targets and will sacrifice some plans with lower returns next year to do so.
Independent Pharmacies Hit Prime Therapeutics with Antitrust Suit Over Alleged Price Fixing
A group representing thousands of pharmacies has filed an antitrust suit against Prime Therapeutics, alleging that the company colluded with rival Express Scripts to fix prices.
CMS Ending Medicare Part D Subsidy Program
The Trump administration announced it will end a subsidy program aimed at keeping premiums low for Medicare Part D beneficiaries.
Bonus Article
Global Hunger Falls Below 8% for the First Time Since the Pandemic
Just for Fun
Math Joke:
Why was the function feeling depressed?
Prior Week
Q: Why are mathematicians great at parties?
A: They know how to integrate.
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