For healthcare payers offering Medicare Advantage and Dual Special Needs Plans (D-SNPs), the translation of member-facing materials is a costly, complex and high-stakes process. Translation requirements place an enormous burden on payers and, yet, it is critical for a positive member experience and accessibility in the U.S., where nearly 68 million people speak a language other than English at home.
The Centers for Medicare & Medicaid Services (CMS) mandates that materials such as Annual
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Medicare Advantage | Payers | News, Analysis, Insights
Wellth Secures $36M to Expand AI-Powered Behavior Change Platform
What You Should Know:
- Wellth, a digital health company specializing in combining daily motivation with behavior change strategies secures $36M in Series C financing led by Mercato Partners, with participation from FCA Venture Partners, Comcast Ventures, and existing investors.
- The funding will be used to expand access to the Wellth app across Medicare Advantage, Medicaid, D-SNP, and other high-need populations. The company will also use the funds to accelerate product innovation
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J.D. Power Study: Medicare Advantage Member Satisfaction Declines Amid Policy Changes
What You Should Know:
- A new report from J.D. Power reveals a significant decline in member satisfaction with Medicare Advantage (MA) plans. The J.D. Power 2025 U.S. Medicare Advantage Study reveals that satisfaction dropped to an average score of 623 out of 1,000, which is down 29 points from the previous year.
- According to the study, the primary cause for this decline is a 39-point drop in members' overall trust in their plans. This trend is occurring in the wake of significant
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Inovalon and AWS Partner to Enhance AI-Powered Solution for Medicare Advantage Audits
What You Should Know:
- Inovalon, a provider of data-driven healthcare solutions, has announced an expanded collaboration with Amazon Web Services (AWS) to enhance its Converged Record Review™ solution.
- The enhancement is in direct response to the new Centers for Medicare & Medicaid Services (CMS) requirement for annual Risk Adjustment Data Validation (RADV) audits for all Medicare Advantage (MA) contracts, beginning in 2026.
Increasing Scrutiny from Health
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New Opportunities for Healthcare AI: Decoding the 2026 Medicare Advantage Rate Hike
Last month, the Centers for Medicare & Medicaid Services (CMS) released its 2026 Medicare Advantage (MA) Rate Announcement, projecting a 5.06% average increase in payments to MA plans. That’s a notable jump from the 3.70% increase we saw in 2025. More than just a financial adjustment, this signals growing confidence in the Medicare Advantage model—and with it, growing expectations.
What does this mean simply? Insurance companies offering these plans will receive more government funding,
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Walmart Unveils Digital Health Innovations to Enhance Medicare Advantage Benefit Use and Promote Healthier Eating
What You Should Know:
- Walmart today announced new digital innovations designed to transform the healthcare shopping experience, specifically aiding customers in maximizing their Medicare Advantage supplemental benefits.
- In a first for retail, select customers can now easily identify plan-specific, benefits-eligible products while shopping on Walmart.com and the Walmart app. Alongside this, Walmart is rolling out "Everyday Health Signals," a new AI-powered digital platform
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Critical Role of Transitions of Care in Medicare Advantage Success
The Medicare Advantage (MA) market is at a tipping point, with more than half of all seniors enrolled in an MA plan for their healthcare. Utilization of services is skyrocketing and the Centers for Medicare and Medicaid Services (CMS) has increased pressure to deliver supplemental benefits in a high-quality, low-cost and reportable manner.
As enrollment continues to grow, how health plans are paid — and how much —will be central to the debate over the efficiency and sustainability of
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How Medicare Advantage Programs Can Address Social Risk and Improve Health Outcomes
There are almost 33 million people enrolled in eligible Medicare programs. Nearly half are enrolled in Medicare Advantage (MA) plans, and that number is expected to continue its climb. While many MA plans offer services that align with social determinants of health (SDOH) goals, there are still gaps in how these services reach and support vulnerable populations. This challenge is multifaceted. Critical issues include:
An incomplete understanding of how MA services impact different SDOHs
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Unpacking Medicare Advantage Terminations and How Plans Can Navigate Them
The U.S. healthcare system has been undergoing its own stress test. Stakeholders are currently experiencing a variety of pressures with a primary focus on finances, including administrative costs. The COVID-19 pandemic is often used as a convenient delimiter for the emergence of these problems, but in reality, tensions were brewing long before now and were caused by a variety of factors. Medicare Advantage (MA) is facing the headwinds of these issues – and as a result, MA
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Revitalizing Medicare Advantage: How The Push to Streamline Prior Authorization Will Impact Senior Care
As a physician, the odds that you’ve had a negative experience related to the prior authorization process are (unfortunately) highly likely. According to the American Medical Association’s (AMA) 2023 Prior Authorization Physician Survey, 1 in 4 physicians report that prior auths “have led to a serious adverse event for a patient in their care.” Think about the toll that this takes on professionals whose primary job is providing lifesaving care, and the thing preventing this care is outside their
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