Federal and state policymakers are actively shaping health coverage and access, and we’re here to explain exactly what these changes mean for plans and providers.

In a new video series, our experts bring real-world industry experience to the latest policy questions. Watch our 5-10 minute explainers:

• What’s Shaping Healthcare Right Now?
  • Series introduction that offers an overview of who we are and top-of-mind issues shaping the US payer environment
• The Impact of CMS and HHS Rules on Responsible AI Use
  • Learn about how CMS and other HHS regulations are shaping AI use in health plans, driving transparency and accountability, and speeding responsible adoption across an increasingly automated system.
• Predictably Unpredictable: Medicare Risk Adjustment
  • Medicare risk adjustment is shifting. We explain recent policy changes, RADV expansion, and how evolving models may affect payments and market strategy.
• Clover Health Wins MA Stars Lawsuit: What’s Next?
  • In this video, we discuss the recent court decision on Clover Health’s Medicare Advantage Stars results lawsuit, and what health plans should be assessing for future potential impacts while appeals and next decisions play out.
• Compliance on Alert: The New Era of Program Integrity
  • This episode spotlights the rising compliance pressures health plans faces, from tougher Fraud, Waste, and Abuse oversight to expanding Program Integrity requirements and new federal scrutiny across operations. In five minutes, Avalere Health experts break down the policies driving these shifts and what plans must watch now to stay compliant.

Curious to dive into any of these topics in more detail? Reach out to our Health Plans and Providers team with questions or to schedule a meeting.

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