The 2026 Final Rule and the 2026 Rate Announcement codified measures most Medicare plans were already prepared for, rebranded a major health equity program and gave a surprising boost in reimbursement. But the big takeaway is how heavily CMS is zeroing in on outcomes across the board and the biggest challenge health plans will face is in improving outcomes for a higher percentage of their populations without increasing costs or member abrasion.
Join a live webinar to learn:
- The impact of the Final Rule and Rate Announcement on a plan’s go-forward strategy and profitability.
- What changes plans could implement to improve health outcomes and member retention and optimize Medical Loss Ratio (MLR).
- Strategies for elevating engagement across all member populations with behavioral science.
- What to evaluate to understand areas of cost savings and measure improvement.
Changing Your Approach: What Medicare Plans Need to do Differently in 2025 and 2026
The 2026 Final Rule and the 2026 Rate Announcement codified measures most Medicare plans were already prepared for, rebranded a major health equity program and gave a surprising boost in reimbursement. But the big takeaway is how heavily CMS is zeroing in on outcomes across the board and the biggest challenge health plans will face is in improving outcomes for a higher percentage of their populations without increasing costs or member abrasion.
Join a live webinar to learn:
- The impact of the Final Rule and Rate Announcement on a plan’s go-forward strategy and profitability.
- What changes plans could implement to improve health outcomes and member retention and optimize Medical Loss Ratio (MLR).
- Strategies for elevating engagement across all member populations with behavioral science.
- What to evaluate to understand areas of cost savings and measure improvement.
Speakers
Mallory has over 15 years of leadership, quality and clinical experience delivering 5-Star quality care for senior populations in managed care plans and assisted living settings. She previously served as the Director of Quality Health Integration at Network Health Plan where she oversaw all regulatory programs and led the plan to achieve 5-Star performance. Mallory is a Registered Nurse and earned her BSN from the University of Wisconsin-Green Bay.
Ana brings more than 20 years of healthcare and health plan experience to Healthmine. She most recently came from WellSense Health Plan, formerly Boston Medical Center HealthNet Plan. She had oversight of work related to Stars, HEDIS®, NCQA, Quality Rating System, External Quality Review Organization, population health programs, new product implementation, value-based care programs, policy advocacy and health equity programs.
Ana developed multiple innovative member and provider interventions that were integral in the successful improvement of key HEDIS and Consumer Assessment of Healthcare Providers and Systems (CAHPS) quality measures and meeting corporate and contractual goals. She has experience with successfully identifying and implementing new to industry initiatives, such as texting, with proven quality and financial improvement. Ana is bilingual in English and Spanish and has used this in community initiatives to help engage members and improve the quality of care for the Medicaid, Medicare, Affordable Care Act, and Commercial populations.
Ana holds a master’s degree from Simmons University in Health Administration and a bachelor’s degree from the University of New Hampshire.
Chris Gage is a senior marketer with first-hand experience designing data-driven, healthcare engagement strategies to improving quality scores, decrease costs and increase member retention. With a strong background in consumer engagement, she has assisted health plans in conducting personalized, omnichannel outreach campaigns to drive behavioral change and improve loyalty.
Changing Your Approach: What Medicare Plans Need to do Differently in 2025 and 2026
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The 2026 Final Rule and the 2026 Rate Announcement codified measures most Medicare plans were already prepared for, rebranded a major health equity program and gave a surprising boost in reimbursement. But the big takeaway is how heavily CMS is zeroing in on outcomes across the board and the biggest challenge health plans will face is in improving outcomes for a higher percentage of their populations without increasing costs or member abrasion.
Join a live webinar to learn:
- The impact of the Final Rule and Rate Announcement on a plan’s go-forward strategy and profitability.
- What changes plans could implement to improve health outcomes and member retention and optimize Medical Loss Ratio (MLR).
- Strategies for elevating engagement across all member populations with behavioral science.
- What to evaluate to understand areas of cost savings and measure improvement.
Featured presenters
Mallory has over 15 years of leadership, quality and clinical experience delivering 5-Star quality care for senior populations in managed care plans and assisted living settings. She previously served as the Director of Quality Health Integration at Network Health Plan where she oversaw all regulatory programs and led the plan to achieve 5-Star performance. Mallory is a Registered Nurse and earned her BSN from the University of Wisconsin-Green Bay.
Ana brings more than 20 years of healthcare and health plan experience to Healthmine. She most recently came from WellSense Health Plan, formerly Boston Medical Center HealthNet Plan. She had oversight of work related to Stars, HEDIS®, NCQA, Quality Rating System, External Quality Review Organization, population health programs, new product implementation, value-based care programs, policy advocacy and health equity programs.
Ana developed multiple innovative member and provider interventions that were integral in the successful improvement of key HEDIS and Consumer Assessment of Healthcare Providers and Systems (CAHPS) quality measures and meeting corporate and contractual goals. She has experience with successfully identifying and implementing new to industry initiatives, such as texting, with proven quality and financial improvement. Ana is bilingual in English and Spanish and has used this in community initiatives to help engage members and improve the quality of care for the Medicaid, Medicare, Affordable Care Act, and Commercial populations.
Ana holds a master’s degree from Simmons University in Health Administration and a bachelor’s degree from the University of New Hampshire.
Chris Gage is a senior marketer with first-hand experience designing data-driven, healthcare engagement strategies to improving quality scores, decrease costs and increase member retention. With a strong background in consumer engagement, she has assisted health plans in conducting personalized, omnichannel outreach campaigns to drive behavioral change and improve loyalty.
