Lessons From 2026 Enrollment

Lessons From 2026 Enrollment

Author: Sponsored by HealthEdge January 16, 2026 Duration: 10:40
Enrollment for 2026 brought major shifts for health plans, driven by new CMS rules, rising consumer expectations, and the growing pressure to modernize operations. This episode explores how plans are rethinking enrollment integrity, broker oversight, digital shopping, data quality, and how emerging interoperability requirements will reshape eligibility, provider data, and automation in the seasons ahead. Tune in to understand how these changes affect the future of enrollment, and how leading ...

Tune in to Current Trends For Payers for a grounded conversation about the forces reshaping health insurance and government-sponsored health plans. Sponsored by HealthEdge, this podcast moves beyond surface-level news to examine the operational backbone required to navigate today's complex landscape. Each episode features direct dialogue with industry experts who understand that real progress hinges on the infrastructure behind the scenes. You'll hear specific discussions on practical areas like leveraging BPaaS and new technology, strengthening data security, and refining core administration processes. We also delve into the critical human elements of care management and member engagement, alongside the metrics that matter, including risk adjustment and HEDIS and Star quality measures. Whether it's strategies for start-up growth or adapting to regulatory shifts, the focus remains on actionable insights that can lead to better business outcomes and, fundamentally, a higher quality of care for members. This is a resource for professionals seeking a deeper understanding of the systems and trends that define success in the payer space.
Author: Language: en-us Episodes: 44

Current Trends For Payers
Podcast Episodes
Digital Tactics For Member Engagement [not-audio_url] [/not-audio_url]

Duration: 10:34
“There’s a whole new range of possibilities for interacting with members through digital medium.” Marketing and communications in the Medicare Advantage space have evolved significantly in the past five years. Leaving be…
Next Generation Care Management Technology [not-audio_url] [/not-audio_url]

Duration: 21:15
"The only way to proactively identify and manage members with rising risk is by connecting care teams with real time data, analytics, and predictive models." In this episode, we explore the origins of care management, re…
Future of Stars [not-audio_url] [/not-audio_url]

Duration: 11:51
“Maintain the spirit of continual improvement across the organization. Even though there is uncertainty, CMS rewards heavily for improvement year over year.” 2021 was the first year that CMS shifted away from clinical me…