Stars Health Equity Change Examined
A great Modern Healthcare article on the Trump administration’s proposal to expunge the Excellent Health Outcomes For All (EHO4all) health equity reward just a month before the second measurement year close. I am one of the Stars experts quoted. I make the argument that there are winners and losers when eliminating EHO4all and keeping the Reward Factor for high-performing plans. I think plans with major dual eligible populations and no near-term expectation of obtaining the Reward Factor could have a colorable argument that the rule does not give plans due process of a change. The switchback will cost Medicare billions.
(Article may require a subscription.)
#cms #medicareadvantage #stars #quality
https://www.modernhealthcare.com/insurance/mh-medicare-advantage-star-ratings-centene-molina
CVS Reports Improved Expectations
At its annual investor day, CVS Health said its outlook for the year will be better than reported and it also gave a positive report for 2026. CVS says full-year 2025 revenue will be at least $400 billion. It says its compound annual growth rate to be in the mid-teens for the next three years. The recovery is in part due to reforms at its multiple units. It also says it is progressing well to returning to target margins at Aetna.
#cvshealth #aetna #margins
https://www.fiercehealthcare.com/payers/cvs-boosts-2025-outlook-unveils-guidance-expectations-2026
Senate Will Vote On GOP Bill Thursday
The Senate will vote Thursday on a GOP proposal to replace enhanced health insurance subsidies with health savings accounts (HSA). An agreed-upon vote on a Democratic expansion for three years will also be held. The Democratic bill is not expected to pass.
Under the Cassidy-Crapo GOP bill, individuals who sign up for a bronze or catastrophic plan on the Exchanges that’s paired with an HSA will receive a contribution. For individuals making up to 700% of the federal poverty level, they will receive $1,000 if aged 18 to 49 and $1,500 if they’re between the ages of 50 and 64.
In the House, a set of moderate GOP members are pushing a two-year extension plan with some conservative reforms. The bill looks much like a bill proposed by two GOP senators.
Additional articles: https://thehill.com/homenews/senate/5640985-thune-cassidy-crapo-health-care-bill-vote/ and https://www.fiercehealthcare.com/payers/trumps-idea-health-accounts-has-been-tried-millions-patients-have-ended-debt and https://www.fiercehealthcare.com/regulatory/crapo-cassidy-introduce-aca-subsidy-plan-leans-hsas and https://thehill.com/policy/healthcare/5641529-congress-tensions-aca-subsidies/ and https://thehill.com/policy/healthcare/5641051-moderate-house-republicans-aca-subsidies-extension/ and https://thehill.com/homenews/house/5641381-fitzpatrick-affordable-care-act-subsidies-bill-obstacles/ and https://www.healthaffairs.org/content/forefront/no-clear-front-runner-extend-aca-subsidies
(Some articles may require a subscription.)
#exchanges #coverage #healthcare
https://www.modernhealthcare.com/politics-regulation/mh-gop-aca-subsidies-extension-hsa-pbm
KFF Analysis of 2026 MA Plans
Healthcare policy group KFF does its usual stellar job in analyzing Medicare Advantage (MA) plans. KFF looks at benefit offerings, premiums, and plan availability in 2026.
Additional article: https://www.kff.org/medicare/medicare-advantage-2026-spotlight-a-first-look-at-plan-premiums-and-benefits/
#medicareadvantage
https://www.kff.org/medicare/medicare-advantage-2026-spotlight-a-first-look-at-plan-offerings/
— Marc S. Ryan
