Wakely Wire

New Insights

Whitepapers, briefs, press releases and more

The Value Shift – How Medicare Advantage Benefits Are Evolving for 2026

On October 30, 2025, CMS released the 2026 MA plan benefit data. This first paper in Wakely’s 2026 MA market paper series provides an initial analysis of the 2026 MA benefit landscape, highlighting key trends and changes for 2026. Using Wakely’s WMACAT and SMART tools, the paper finds that general enrollment MA plans experienced notable ... Continue reading

Continue reading

Events & More

Proposed ACA 2027 Notice of Benefit and Payment Parameters: Implications for Issuers and States

WAKELY WEBINAR
March 11, 2026 | 12 PM ET

This webinar offers a timely, strategic overview of the recently released proposed 2027 Notice of Benefit and Payment Parameters and what it signals for the evolving coverage landscape. We will unpack the key policy changes, operational requirements, and market assumptions embedded in the rule, with a focus on implications for the individual and small group markets beginning in 2026 and extending beyond.

Participants will gain insight into how proposed updates may affect plan design, rate development, risk adjustment, enrollment operations, and health insurance regulation dynamics. We will also explore the broader policy direction reflected in the proposal and what organizations should be monitoring now to prepare for implementation and potential downstream impacts.

Learn more and register

Newsworthy Findings

CMS Extends Application Deadline for New Medicaid Drug Pricing Model

The White House said Monday afternoon that it will extend the deadline for drugmakers to apply for a new model that seeks to establish most-favored nation pricing in Medicaid. The Centers for Medicare & Medicaid Services said that the application deadline for the new GENErating cost Reductions for U.S. Medicaid (GENEROUS) model will be pushed back from March 31 to April 30 to allow pharmaceutical companies greater time to sign up.

Read full article
Editor's Note
CMS has extended the application deadline for drug manufacturers to participate in its new Medicaid pricing pilot, the GENEROUS model, while keeping the final participation deadline of June 30. The model will allow participating state Medicaid programs to purchase certain drugs at prices aligned with those paid in other countries, with CMS negotiating directly with manufacturers to lower costs. The initiative aims to reduce Medicaid drug spending, which reached $100 billion in 2024, and ensure more consistent, affordable access to medications for vulnerable Americans.

CMS Receives Record Comments on Controversial Medicare Advantage Payment Proposal

The Trump administration wants to keep MA rates flat next year and change how risk adjustment is calculated. Insurers had a lot to say about this.

Read full article
Editor's Note
Federal regulators received a record of 47,000 comments on their proposal to keep 2027 Medicare Advantage rate increases below 0.1%, as insurers intensify lobbying efforts for higher reimbursements. Insurers argue the flat rates and tighter risk adjustment rules would force benefit cuts and plan exits for the program’s 35 million enrollees, while CMS officials say they are focused on improving payment integrity amid concerns of overpayments. A key dispute centers on projected medical spending growth, with even a 1 percentage point increase in the effective growth rate significantly boosting plan payments.

Iran War Prompts U.S. Hospitals to Prep for Potential DDoS Attacks

The Health Information Sharing and Analysis Center is warning American health systems to shore up their cybersecurity posture against the threat of distributed denial-of-service attacks stemming from the military conflict with Iran.

Read full article
Editor's Note
Health-ISAC is urging U.S. health systems to treat the Iran conflict as a trigger for elevated disruption risk, especially DDoS against public-facing assets like portals and VPNs, and to validate DDoS protections with ISPs/CDNs, harden internet-facing systems, and rehearse downtime/incident-response workflows so clinical operations can continue during outages.

Amazon Launches Suite of Healthcare AI Agents

Amazon Connect Health can help patients schedule appointments as well as assist providers by creating summaries of patients’ medical histories, documenting care and generating medical codes.

Read full article
Editor's Note
Amazon Connect Health can help patients schedule appointments as well as assist providers by creating summaries of patients’ medical histories, documenting care and generating medical codes.

Lawmakers, Health Groups Resist States’ Rural Health Fund Plans

State lawmakers and rural health advocates are pushing back on how states plan to use new federal rural health transformation funds, arguing they had little input in the process and that the money may not directly support struggling rural hospitals.

Read full article
Editor's Note
The controversy highlights the fragile financial ecosystem underpinning rural healthcare. If federal programs fail to stabilize rural hospitals, insurers - particularly Medicare Advantage and Medicaid managed care plans - could face shrinking provider networks, access challenges, and rising pressure to support alternative care models in underserved areas.

Bonus Article

Just for Fun

Math Joke:

Why did Pi break up with i?

Prior Week

Q: Why did the student do multiplication on the floor?

A: The teacher told them not to use tables

Sign up for the
Wakely Wire,

our industry newsletter.