The Future of Health Plans

The health insurance market is expected to shift significantly over the
next decade. We work with health plans to chart a course forward.

Overview

Navigating Through a Changing Landscape

The policy and regulatory landscape that health plans operate in is changing rapidly. Developments such as Medicare Part D redesign, changes to the Medicaid quality rating system, new therapies such as GLP-1s, and evolving technologies like artificial intelligence, will continue to evolve how plans operate and deliver care. Plans cannot wait for the dust to settle on these changes. They should be preparing for tomorrow’s changes to the healthcare market today. ​

Our experts help health plans analyze the changing market to inform strategic decision making. We support end-to-end strategy—from ideation to implementation—business process optimization, and compliance reviews to help set plans up for success. ​

Health Plans Expertise
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Federal and State Dynamics in AI Regulation

Avalere Health Advisory experts unpack the recent state legislative activity around AI in healthcare, exploring recent trends, the impact of federal executive orders, and key considerations for industry stakeholders as they navigate these shifts.

Impacts to Insurance Markets, 2026 and Beyond

Avalere Health experts discuss how they developed and deployed an analytic model to predict likely enrollment changes to assist clients in understanding the impacts on all lines of business as a result of upcoming federal policy changes.

Inside the Latest RADV Regulatory Developments

Avalere Health Advisory experts break down major updates to the CMS Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) audit process, including enhanced technology, workforce expansion, and increased audit volume, and how health plans can prepare.

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