Weekly Roundup -
March 4, 2026
Smart. Strategic. Essential.
Unmatched Healthcare Insights from ºìÁì½í¹Ï±¨,
Leavitt Partners & Wakely.
Featured:
Webinar Replay – Proposed ACA 2027 Notice of Benefit and Payment Parameters: Implications for Issuers and States
ACCESS WEBINARTrending: In Focus
The Value Shift in Medicare Advantage: What 2026 Benefits Tell Us About the Market’s Next Chapter
The Medicare Advantage (MA) program continues to evolve as plans respond to shifting policy signals, market pressures, and beneficiary expectations. A new paper from Wakely, an ºìÁì½í¹Ï±¨ Company——providesÌýaÌýdata-drivenÌýexamination ofÌýhow MA benefit designs are changing and what those changesÌýsignal about the futureÌýdirection of the program.Ìý
This paper refreshesÌýWakely’s ongoingÌýMAÌý, updatingÌýÌýwith the latest 2026 planÌýenrollmentÌýdata.ÌýIt builds on Wakely’s established work examining benefit design, supplemental offerings, and the relationship between bids, rebates, and plan value, includingÌý.Ìý
ThisÌýarticleÌýhighlights findings fromÌýthe proprietary value-addÌýmetric that Wakely developed to provide aÌýcomprehensive assessment of MA plan value.ÌýAlthoughÌýit can be used as aÌýcomparative metric to evaluate relative changes year over year, it is not intended toÌýrepresentÌýpricing.Ìý
FromÌýBenefitÌýExpansion to OptimizationÌý
Over the past decade, MA plansÌýhaveÌýsteadily expanded benefit offerings,ÌýsupportedÌýbyÌýstrong enrollment growth and favorableÌýrebateÌýdynamics. The 2026Ìýbenefit landscapeÌýsuggestsÌýthatÌýplansÌýhave beenÌýtakingÌýa more measured approachÌý(seeÌýFigure 1). Wakely’s analysis finds that plans are becoming more strategic in how benefits are designed and deployed,ÌýmaintainingÌýor enhancing benefits that areÌýbestÌýaligned with quality performance, affordability, and target populationsÌýwhileÌýpulling back in other areas.Ìý
PlansÌýappear to beÌýoptimizing benefits to better align with member needs, quality performance, and financialÌýparameters.ÌýExamplesÌýinclude refining supplemental benefits, adjusting cost-sharing structures, and rethinking how benefits support care management and health outcomes.Ìý
Figure 1. Change in Plan Value-Add from 2025 to 2026
ÌýThe shift reflectsÌýanÌýMA marketÌýin whichÌýdifferentiation and long-term sustainability are increasingly important.Ìý
Supplemental Benefits: More Targeted, MoreÌýStrategicÌý
Supplemental benefitsÌýremainÌýa defining feature of Medicare Advantage, but their role is evolving.ÌýWakely’sÌýpaper highlightsÌýa move away fromÌýexpanding the number of benefitsÌýtowardÌýtargetedÌýbenefitÌýofferingsÌýthat are more clearly connected to member engagementÌýand outcomes.Ìý
PlansÌýareÌýhomingÌýtheir focus on benefits that support daily living, chronic condition management, and access to care,Ìýparticularly for populations with higher needs. This targeted approach suggests plans are thinking aboutÌývalue, operational complexity, and how benefits contribute to overall value propositions.Ìý
Between 2025 and 2026, the percentage of members with access to common supplemental benefits has, on average, stayed consistent or slightly decreased among the general enrollment populationÌý(FigureÌý2). The percentage of members who are enrolled in plans that offerÌýover-the-counterÌý(OTC) drug, transportation, and Flex Card benefits has decreased by 11Ìýpercent, 6Ìýpercent, and 4Ìýpercent, respectively. Conversely, theÌýDual Eligible Special Needs Plan (D-SNP)Ìýpopulation sawÌýanÌýincrease in member access toÌýallÌýsupplemental benefit categories except transportation (an 8%Ìýdecrease).Ìý
FigureÌý2. Percent of Enrollment in Common Supplemental BenefitsÌý
For stakeholders across the healthcare ecosystem, this trend underscores the importance ofÌýunderstanding not just what benefits are offered, but why.Ìý
Shifts inÌýCostÌýSharing andÌýtheÌýEnrolleeÌýExperienceÌý
Wakely’s analysis also points to notable shifts inÌýcostÌýsharingÌýand premiumÌýstructures.ÌýThere isÌýcontinued attention to balancing affordability for members with the need to manage plan liability amid changing benchmarks andÌýutilizationÌýpatterns.Ìý
These decisions directlyÌýaffectÌýtheÌýmemberÌýexperience. Small shifts in copays, deductibles, or benefit limits can influence enrollment, retention, and satisfaction,Ìýparticularly in competitive markets. As plans fineÌýtune these levers, data-driven insights become critical to understanding how benefit changes may resonate with different member segments.Ìý
2026ÌýSignals for Future Bid CyclesÌý
The benefit trendsÌýidentifiedÌýinÌý“The Value Shiftâ€ÌýseriesÌýsuggest several broader signals for the MA market:Ìý
- Value over volume: Plans are prioritizing benefits that support quality, outcomes, and sustainable growth.Ìý
- Greater segmentation: Benefit designs are increasingly tailored to specific populations and market dynamics.Ìý
- Data-informed decision-making: As margins tighten, plans are relying more heavily on analytics to guide benefit strategy.Ìý
- Special needs plans continue to drive growth.ÌýEnrollment in Chronic Condition Special Needs Plans (C-SNPs)ÌýisÌýthe fastest-growing segmentÌýin MA.Ìý
These dynamics have implications for MA organizationsÌýandÌýforÌýproviders, policymakers, and partnersÌýseekingÌýto understand how MA continues to shape care delivery andÌýcosts.Ìý
Value-Add MetricÌýandÌýBenefit DesignÌýInsightsÌý
In this paper,ÌýWakelyÌýpaired itsÌýactuarial and analyticÌýexpertiseÌýwith tools that enable detailed benefit and market analysis. One of those tools,ÌýWakely’sÌýÌý(WMACAT),Ìýcalculates a comprehensiveÌývalue-add metric that integrates five core components into a consistent framework that allows for apples-to-apples comparisons across plans, markets, and years. In addition,ÌýWakely’sÌýÌý(SMART) supports broader competitive assessments by layering enrollment weighting, geographic variation, and plan positioning into the analysis.Ìý
AsÌýan ºìÁì½í¹Ï±¨Ìýcompany, Wakely’s work is complemented by broader policy, market, and strategyÌýexpertise,Ìýhelping organizations connect benefit decisions to regulatory developments, operational considerations, and long-term goals.Ìý
For health plans and healthcare organizations navigating the next phase of Medicare Advantage, these combined capabilities canÌýrespond toÌýquestions such as:Ìý
- How competitive is our benefit design today,Ìýand where are the risks?Ìý
- Which benefits are most aligned with our population and quality strategy?Ìý
- How might future policy or payment changes affect benefit sustainability?Ìý
Looking AheadÌý
MA benefit designÌýremainsÌýan important signal of market directionÌýbyÌýshowingÌýhow plans are responding to policy change, market competition, and financial pressure. As plans shift from broad expansion to more targeted value strategies, the ability to measure, compare, and interpret benefit changes becomes essentialÌýas plans look ahead to the 2027 and 2028 bid cycles.Ìý
Wakely will continue to build on this work with upcoming analyses, including deeper dives into Part D design changes and the implications of theÌýsunset of the Value-Based Insurance Design (VBID)Ìýprogram.Ìý
For information about this analysis and the WakelyÌýtools, contactÌýÌýandÌý.Ìý
Federal Policy News
Fueled By Weekly Health Intelligence
Vaccine Policy Debate Intensifies as Surgeon General Nomination Advances
Although absent from last week’s State of the Union address, the Make America Health Again (MAHA) agenda, particularly with respect to vaccine policy, is continuing to have aÌýsignificant influenceÌýonÌýthe US Department of Health and Human ServicesÌý(HHS)Ìýand Congress. Last week, during the Senate HELP Committee’s nominationÌý for Surgeon General nominee, Dr. Casey Means, HHS Secretary Robert F. Kennedy’s recent actions impacting vaccine policy, in addition to the witness’s own perspective on vaccines, were a focal point for both Republicans and Democrats. Chair Bill Cassidy (R-LA), along with other majority members of the committee, was generally supportive of Dr. Means’ chronic disease and nutrition focus, but expressed concern regarding her responses to vaccine-related questions, including hepatitis B universal immunization recommendations, the MMR vaccine, flu vaccine recommendations, and the concept of “shared clinical decision-making,†which she encouraged in her responses to these questions. Chair Cassidy underscored concerns regarding increasing vaccine skepticism in the U.S., citing data that the ongoing measles outbreak in the U.S. has Ìý1,000 cases in 2026 alone, and that the U.S. is at risk of losing its measles elimination status. In addition to the data cited by the Senator, recentÌýÌýfrom the Yale School of Public Health, found that an annual decline in measles, mumps, and rubella (MMR) vaccine coverage of 1 percent over the next five years could lead to more than 17,000 measles cases, 4,000 hospitalizations, and 36 preventable deaths per year, costingÌý$1.5 billionÌýannually.Ìý
While a markup to vote on the nomination has not yet been scheduled, a simple majority is needed to advance the nomination of Dr. Means out of committee.ÌýÌý
Meanwhile, on February 27, Secretary KennedyÌýÌýtwo new members of the Advisory Committee on Immunization Practices (ACIP) ahead of its upcoming meeting on March 18 and 19.ÌýThe two new members are Dr. Sean Downing, a practicing primary care physician, and Dr. Angelina Farella, a practicing pediatrician.ÌýAccording to statements from Secretary Kennedy and new Acting Centers for Disease Control and Prevention (CDC) Director Jay Bhattacharya in the HHS press release announcing the appointments, the new members are expected to provide the perspectives of practicing physicians who implement the recommendations made by ACIP. Notably, Dr. Farella had been outspoken against the COVID-19 vaccine, reportedly having testified in front of the Texas Senate that the vaccine should be removed from the market. The March ACIP meeting Ìýincludes discussion of COVID-19 vaccine injuries, long-COVID, and ACIP recommendationÌýmethodology. The meeting may also include recommendation votes related to COVID19 vaccine injuries and long-COVID, as well as ACIP recommendationÌýmethodology. Public comments for the rescheduled ACIP meeting will be accepted from March 2–12, 2026.Ìý
 Separately, the Vaccines and Related Biological Products Advisory Committee (VRBPAC), whichÌýadvisesÌýthe US Food and Drug Administration (FDA),ÌýÌýits next session will take place on March 12, 2026. VRBPAC is slated to discuss and make recommendations on the strain composition of influenza virus vaccines for use in the United States during the 2026–2027 influenza season.Ìý
CMS Defers Medicaid Funds, Imposes DME Moratorium in Anti-Fraud Push
On February 25,ÌýÌýandÌýÌýannounced a three-part “crackdown†on Medicare and Medicaid fraud. The announced actions include deferring $259.5 million in quarterly federal Medicaid matching funds to Minnesota while CMS completes a program-integrity review in the state. Specifically, CMS pointed to $243.8 million in unsupported and potentially fraudulent claims, as well as $15.4 million tied to Medicaid claims for individuals lacking satisfactory immigration status. CMS also flagged what it characterized to be unusually rapid growth in personal care, home- and community-based services, and other practitioner spending in the state. CMS noted the stateÌýcanÌýrespond withÌýadditionalÌýinformation and documentation during the review, but the deferrals in federal funding could increase if deficiencies persist.ÌýÌý
Second, CMSÌýÌýa six-month nationwide moratorium effective February 27 on new Medicare enrollment for certain Durable Medical Equipment, Prosthetic Devices, Prosthetics, Orthotics, & Supplies (DMEPOS) suppliers, due to concernsÌýregardingÌýthe prevalence of fraud within the spending area. The agencyÌýidentifiedÌý$1.5 billionÌýin suspected fraudulent DMEPOS billing last year.ÌýÌý
Finally, CMS announced it is seeking stakeholder input to inform development of future potential rulemaking under the Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative. In theÌý, CMS seeks stakeholder input onÌýadditionalÌýanti-fraud tools and potential regulatory changes across Medicare, Medicaid, CHIP, and the Marketplace. The RFI specifically requests information on several possible anti-fraud measures, including “enhanced identity proofing and ownership requirements†(for Medicare-enrolled providers or suppliers), using AI toÌýassistÌýwith Medicare Advantage coding, and opportunities to support state Medicaid program integrity. The RFI is open for public comment until March 30.Ìý
Education Department Shifts School Safety Programs to HHS
On February 23, the Department of Education (ED)ÌýÌýa new interagency agreement (IAA) with HHS to transfer management of several ED programs focused on school safety and emergency preparedness to HHS as a part of the Trump Administration’s efforts to downsize the ED. It was previouslyÌý in November that HHS would now manage the National Committee on Foreign Medical Education and Accreditation (NCFMEA) and Child Care Access Means Parents in School (CCAMPIS) Partnership, previously administered by ED. HHS will now also administer the School Emergency Response to Violence (Project SERV), School Safety National Activities, Ready to Learn Programming, Full-Service Community Schools, Promise Neighborhoods, and Statewide Family Engagement Centers programs. While no specific administrative, funding, or staffing changes for HHS were announced, this partnership will make HHS responsible for managing funding competitions and providing technicalÌýassistanceÌýto several initiativesÌýregardingÌýschool safety, while ED will provide “proper oversight.â€Ìý
HELP Committee Advances Living Donor and Cybersecurity Bills
OnÌýFebruary 26, the Senate HELP CommitteeÌýÌýto advance two key healthcare bills out of committee. The first health-related bill,Ìý, was introduced by Senators Kirsten Gillibrand (D-NY) and Tom Cotton (R-AR) and agreed to by a vote of 22-1. The bill clarifies eligibility for time off under the Family Medical Leave Act (FMLA) and prohibits insurers from discriminating against living donors in life, disability, and long-term care insurance. The committee also advancedÌý, sponsored by Chair Bill Cassidy (R-LA) and Senators Maggie Hassan (D-NH), John Cornyn (R-TX), and Mark Warner (D-VA). The bill seeks to strengthen the healthcare sector’s preparedness against cyberattacks and was agreed to by a vote of 22-1. The House version of the Living Donor Protection Act,Ìý, has not yet been advanced by the House Energy and Commerce Committee, whileÌýthe Health CareÌýCybersecurity and Resiliency Act does not have a House companion.ÌýÌý
Ready to talk about your organization's challenges?
Schedule a ConsultationState Policy News
Alaska
Alaska Opens Letter of Interest Portal for RHTP Funding. The Alaska Department of Health  on February 18, 2026, that it has opened its Letter of Interest (LOI) portal for organizations interested inÌýparticipating in the state’s implementation of the federal Rural Health Transformation Program. Organizations interested in RHTP funding can submit a LOI with project proposals aligning with one of Alaska’s RHTP initiatives: maternal and child health, expanding access to essential services closer to home, promoting healthy communities and preventative care, advancing value-based care and fiscal sustainability, strengthening the health care workforce, and modernizing technology infrastructure. Responses are due March 11, 2026, and funding awards are expected to begin in spring 2026.Ìý
Florida
Florida Lowers AIDS Drug Assistance Program Eligibility; CMS to Hold Marketplace Special Enrollment Period. This monthÌýthe Florida Department of Health (DOH)ÌýÌýan emergency rule that lowered eligibility for the AIDS Drug Assistance Program (ADAP) to 130 percent of the federal poverty level and limited insurance coverage of a once-daily pill that treats HIV used by 60 percent of people in ADAP, effective forÌý90 daysÌýbeginning March 1, 2026. DOH cited funding concerns as the reason for the cuts. Previously, individuals making up to 400 percent of the federal poverty level could enroll in ADAP, which provides free FDA-approved HIV medication to eligible low-income, uninsured, or underinsured individuals. Approximately 30,000 individuals were enrolled in the program before the emergencyÌýruleÌýand advocates estimate that up to 16,000 could be disenrolled. The Centers for Medicare & Medicaid Services (CMS)  a special enrollment period for affected individuals to choose a new Marketplace plan by April 30, 2026.Ìý
Illinois
IllinoisÌýto Release Specialty Managed Care Plan for Foster Care Youth RFP in Summer 2026.ÌýThe Illinois Department of Children and Family Services (DCFS)  in FebruaryÌý2026 that itÌýanticipatesÌýreleasing a request for proposals (RFP) for the Specialty Managed Care Plan for Youth in Care and Former Youth in Care in late summer 2026. DCFS is holding a stakeholder listening session on March 5, 2026,Ìýallowing public commentsÌýto inform the procurement process on how care should be delivered in the program, which is currently calledÌýYouthCare. The department will begin itsÌýreprocurementÌýprocess in spring 2026, and the new contract isÌýanticipatedÌýto begin in January 2028. Centene is the incumbentÌýYouthCareÌýcontractor.Ìý
Iowa
Iowa Issues RHTP Rural Workforce Recruitment, Medical Equipment RFP.ÌýThe Iowa Department of Health and Human Services released two requests for proposals (RFPs) under the state’s Rural Health Transformation Program (RHTP) aimed at strengthening rural healthcare capacity. The  RFP focuses on recruiting healthcare providers to practice in rural communities through incentives such as recruitment bonuses, relocationÌýassistance, and other financialÌýsupportsÌýfor full-time providers. The contract runs from June 1, 2026, to September 30, 2031, and is worth $5 million. The  RFP seeks applicants toÌýprocureÌýand install advanced medical equipment, such as CT scanners, radiotherapy units, and robotic surgical systems, to expand access to specialty services in rural areas. IowaÌýanticipates awarding approximately $50 million across roughly 25Ìýawards for the medical equipment initiative. Applications for both opportunities are due April 9, 2026, with awards expected to be announced on or around May 22, 2026.Ìý
Minnesota
Minnesota Files Lawsuit to Challenge Federal Withholding of Medicaid Funds. OnÌýMarchÌý2, 2026,ÌýtheÌýMinnesotaÌýAttorney General’s office ÌýitÌýhas filed a federal lawsuit seeking to block the Trump administration’s withholding of approximately $243 million in Medicaid funding followingÌýthe federal government’s decision toÌýtemporarilyÌýpauseÌýfunding dueÌýtoÌýitsÌýfraud concerns. The stateÌýargues the action, which represents about 7 percent of its quarterly Medicaid allocation, was implemented without adequate procedural justification or formal findings of noncompliance. The administration has described the pause as part of broader fraud oversight efforts. The lawsuit names theÌýUSÌýDepartment of Health and Human Services and the Centers for Medicare & Medicaid Services, as well as their respective leaders, HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz, in their official capacities.Ìý
North Carolina
North Carolina Medicaid Director Jay Ludlam Steps Down. InÌýFebruary, North Carolina MedicaidÌýÌýthatÌýMedicaid Director Jay Ludlam is stepping down. Assistant secretary of Medicaid Melanie Bush was named interim director.ÌýLudlamÌýis slated toÌýbecome Plan President with Molina Healthcare.Ìý
Private Market News
Fueled By
BrightSpring Closes $238.5 Million Deal to Acquire UnitedHealth Home Health, Hospice Facilities
BrightSpringÌýHealth Services has closed a $238.5 millionÌýÌýto acquire 107 home health and hospice facilities from UnitedHealth Group. The deal was a part of an antitrustÌýÌýwith the Department of Justice that required United to sell some of its home health locations toÌýacquireÌýthe provider Amedisys forÌý$3.3 billion.Ìý
Our Insights
Fueled By Experts Across Our ºìÁì½í¹Ï±¨ Companies
ºìÁì½í¹Ï±¨
Webinar: Proposed ACA 2027 Notice of Benefit and Payment Parameters: Implications for Issuers and States
ThisÌýwebinarÌýoffersÌýa timely, strategic overview of the recently released proposed 2027 Notice of Benefit and Payment Parameters and what it signals for the evolving coverage landscape. We will unpack the key policy changes, operational requirements, and market assumptions embedded in the rule, with a focus on implications for the individual and small group markets beginning in 2026 and extending beyond.
Wakely
The Value Shift – How Medicare Advantage Benefits Are Evolving for 2026
This updated paper builds on Wakely’s prior analysis of Medicare Advantage benefit design, incorporating newly released 2026 enrollment data to provide a clearer picture of how market dynamics are evolving. With refreshed enrollment figures, the analysis reassesses whichÌýbenefitÌýstrategies are gaining traction, where growth is concentrating, and how shifts in enrollment are aligning with plan design and competitive positioning.Ìý
LEAD: The Big Shift Beyond Attribution and Benchmarks-Quality as a Cash Flow Lever
TheÌýLEAD (the Long-term Enhanced ACO Design) Model is the Centers for Medicare & Medicaid Innovation Center’s newest –focused model. Set to launchÌýasÌýACO REACH (Realizing Equity, Access, and Community Health) sunsets at the end of 2026, LEADÌýdirectly linksÌýquality performance to benchmark dollars through a withhold, with 3% of the benchmark withheld upfront and only earned back through quality results. In practical terms, quality becomes a revenue protection lever.ÌýThis paperÌýidentifiesÌýthe changesÌýin the LEAD compared to the ACO Reach model;Ìýways the model is changing the financial conversations, and organizational readiness for these changes.ÌýÌý
RFP Calendar
RFP Calendar
| Date | State/Program | Event | Beneficiaries |
|---|---|---|---|
| Date: February 2026 - DELAYED | State/Program: Illinois | Event: Awards | Beneficiaries: 2,400,000 |
| Date: March 20, 2026 | State/Program: Hawaii Community Care Services | Event: Proposals Due | Beneficiaries: 5,500 |
| Date: April 10, 2026 | State/Program: Hawaii Community Care Services | Event: Awards | Beneficiaries: 5,500 |
| Date: May 1, 2026 | State/Program: Nevada Children's Specialty | Event: Proposals Due | Beneficiaries: NA |
| Date: May 12, 2026 | State/Program: Nevada CO D-SNP | Event: Awards | Beneficiaries: 88,000 |
| Date: June 24, 2026 | State/Program: Wisconsin LTC GSR 3 | Event: Awards | Beneficiaries: 56,000 (all GSR) |
| Date: Summer 2026 | State/Program: Illinois Foster Care | Event: RFP Release | Beneficiaries: 33,000 |
| Date: July 1, 2026 | State/Program: Hawaii Community Care Services | Event: Implementation | Beneficiaries: 5,500 |
| Date: July 28, 2026 | State/Program: Nevada Children's Specialty | Event: Awards | Beneficiaries: NA |
| Date: August 2026 | State/Program: Indiana | Event: RFP Release | Beneficiaries: 1,400,000 |
| Date: January 1, 2027 | State/Program: Illinois | Event: Implementation | Beneficiaries: 2,400,000 |
| Date: January 1, 2027 | State/Program: Nevada CO D-SNP | Event: Implementation | Beneficiaries: 88,000 |
| Date: January 1, 2027 | State/Program: Wisconsin LTC GSR 3 | Event: Implementation | Beneficiaries: 56,000 (all GSR) |
| Date: January 1, 2027 | State/Program: Illinois Tailored Care Management Program | Event: Implementation | Beneficiaries: 22,400 |
| Date: July 1, 2027 | State/Program: Nevada Children's Specialty | Event: Implementation | Beneficiaries: NA |
| Date: January 1, 2028 | State/Program: Wisconsin LTC GSR 4,6 | Event: Implementation | Beneficiaries: 56,000 (all GSR) |
| Date: Fall 2027 | State/Program: Oregon | Event: RFP Release | Beneficiaries: 1,200,000 |
| Date: 2028 | State/Program: North Carolina | Event: RFP Release | Beneficiaries: 2,200,000 |
| Date: 2029 | State/Program: California | Event: RFP Release | Beneficiaries: NA |

