Certifi, Inc

A new report analyzes the trends and dynamics of the Medicare Advantage (MA) market, revealing a period of correction following years of rapid expansion. While growth has tempered, the long-term outlook remains positive, particularly with anticipated support from the new Trump Administration. However, health plans face immediate challenges related to financial performance and sustainability. Learn more: https://hubs.ly/Q03g_v3v0

A contract initially publicized as canceled on the Department of Government Efficiency’s (DOGE) "wall of receipts" website, intended to modernize a provider enrollment system, has now been quietly removed from the site. This opaque action raises questions about transparency and the true status of the project. Learn more: https://hubs.ly/Q03g-WTx0

With shifts in political control, modifications to Medicaid funding, long proposed by Republicans, could become a reality. These proposals center around moving away from the current system where the federal government pays a fixed percentage of a state's Medicaid costs towards spending caps. Learn more: https://hubs.ly/Q03cZDjt0

At Google Cloud Next 2025, Google Cloud announced significant advancements in its generative AI capabilities, focusing on the development and deployment of AI agents designed to automate tasks and collaborate across healthcare organizations. Learn more: https://hubs.ly/Q03g--hp0

In a significant move to reduce expenditures, the Department of Health and Human Services (HHS) has announced plans to cut contract spending by 35% across all of its divisions. This latest clawback comes amidst a series of other funding adjustments within the agency. Learn more: https://hubs.ly/Q03g-WTn0

Finish 2025 strong with a focus on data-driven decision making. To help you stay ahead of the curve, here is a list of 16 essential IT benchmarking metrics for health insurance organizations: https://hubs.ly/Q0376JKZ0

CareSource, a nationally recognized nonprofit managed care organization, has officially completed its acquisition* of Commonwealth Care Alliance, a fellow nonprofit and mission-driven healthcare services organization based in Massachusetts. This strategic move aims to enhance care for individuals with the most significant health needs. Learn more: https://hubs.ly/Q03g-JZz0

The Trump administration's recent decisions have delivered substantial victories to Medicare Advantage (MA) plans, contrasting sharply with the funding cutbacks and regulatory battles faced by other healthcare sectors. Learn more: https://hubs.ly/Q03g-JC90

CMS has issued strict new deadlines for states to comply with Medicaid and CHIP renewal requirements. States must now: - Prioritize Ex Parte Renewals: Utilize existing data to renew eligibility without requiring beneficiary action. - Streamline the Renewal Process: Provide simple renewal forms and multiple submission options. - Ensure Comprehensive Eligibility Checks: Assess eligibility for all Medicaid programs. - Provide Transition Assistance: Help those losing Medicaid enroll in other affordable coverage. Why the Stricter Rules? Many states faced challenges during the initial unwinding phase, leading to potential coverage losses for eligible individuals. CMS aims to prevent future issues and ensure smooth transitions. Learn more: https://hubs.ly/Q02_N10w0

New York State's overhaul of its $9 billion Consumer Directed Personal Assistance Program (CDPAP), a crucial Medicaid home health program, is facing increasing pressure not only from advocacy groups but now also from the federal government. Learn more:https://hubs.ly/Q03g-G_k0