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Becker’s Payer Issues Roundtable Recap: Key insights for health plan leaders

At this year’s Becker’s Payer Issues Roundtable, one message came through consistently: the challenge for payer organizations isn’t new ideas. They need execution that measurably bends trend while keeping decisions defensible in a more scrutinized environment. Across markets, leaders described a world of tighter margins, higher acuity, member disruption, and growing expectations that plans will … Becker’s Payer Issues Roundtable Recap: Key insights for health plan leaders

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From readiness to reality: What TEAM’s first year is really testing

In January 2026, CMS’s Transforming Episode Accountability Model (TEAM) moved from policy to practice. For hospitals in mandatory regions, TEAM is no longer something to prepare for on paper; it is live, operational, and beginning to influence how episode performance is evaluated clinically, financially, and operationally. Many organizations are entering 2026 with a measured posture. … From readiness to reality: What TEAM’s first year is really testing

Medicare Advantage 2026: Breaking down the new risk model and its impact in plain terms

The Centers for Medicare & Medicaid Services (CMS) introduced CMS-HCC Version 28 (V28) in 2024 as the next evolution of Medicare Advantage (MA) risk adjustment. For many organizations, the “new CMS-HCC model” felt more theoretical than operational, something plans were preparing for but not fully experiencing. That changes in 2026, when V28 becomes operational at … Medicare Advantage 2026: Breaking down the new risk model and its impact in plain terms

How CareFirst BlueCross BlueShield modernized analytics to cut cost of care

Health plans are walking a tightrope. On one side, utilization is climbing and breakthrough therapies, while clinically promising, are reshaping cost curves. On the other hand, members, employers, and providers expect more convenience, transparency, and value. The mandate is clear: deliver better outcomes and experiences without sacrificing affordability. Meeting that mandate requires more than more … How CareFirst BlueCross BlueShield modernized analytics to cut cost of care

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Physician performance enablement: Engaging providers with actionable insights for ACO success

Many organizations now have access to more data than ever before, yet they often struggle to transform this information into practical actions that lead to real improvements in population health. Physicians play a vital role in this process and should be involved early when turning data into meaningful insights that are practical, effective, and aligned … Physician performance enablement: Engaging providers with actionable insights for ACO success

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HIMSS26: From data foundations to operational execution in healthcare AI

The HIMSS Global Health Conference and Exhibition has long served as a signal for where healthcare technology is headed. This year’s conference, attended by more than 24,000 healthcare leaders, reflected an industry that has moved past curiosity and into a more demanding phase of transformation. Artificial intelligence (AI), interoperability, and digital infrastructure remained central topics … HIMSS26: From data foundations to operational execution in healthcare AI

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