Insights & Perspectives

MCRA Members Avalere Health and Command Direct engaged in a panel discussion moderated by Desiree Vuocolo, Director of Programs and Partnerships. They discussed new Medicaid community engagement requirements.

Medicaid is entering a period of significant change. New work requirements, shifting financing models, rising healthcare costs, and growing pressure on state budgets are creating new challenges for managed care organizations, while the need to improve access, experience, and outcomes remains as important as ever. MCRA Members GoMo Health and Avalere Health team up to offer insights on the Medicaid policy changes and how managed care organizations can respond.

Avalere Health explains some of the details of Medicaid work requirements, including how activities of daily living may factor in and some of the leeway states have in how they are applied.

Medicaid work requirements are expected to start January 2027, with narrower exemptions than anticipated. Learn how life sciences companies, plans, and providers can support patients.

CMS will be re-calculating 2027 QBP ratings following the May 2026 Clover ruling. Avalere Health experts share insights on potential future directions for the MA Star Rating program.

Part B drugs will be subject to IRA price negotiation for the first time in 2028, introducing new payment uncertainties for Medicare Advantage plans.