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October 1, 2026

Takeaways from the most recent news in the technology and policies shaping healthcare.

Payers

Why MA Plans Now Obsess Over the First Day After Discharge

The 24 hours after a patient leaves the hospital have become a focus for Medicare Advantage plans trying to protect their star ratings, according to Healthcare Dive. That window is when medication errors, missed follow-ups, and confusion drive avoidable readmissions, the outcomes that weigh heavily in CMS quality measures.

Star ratings are not just a scorecard. High marks unlock bonus payments and let plans reinvest in richer benefits, while low ratings can trigger enrollment penalties and lost revenue. As CMS raises the bar and cut points climb, plans can no longer treat post-discharge care as an afterthought.

In practice, leading plans are moving toward earlier and more structured outreach: confirming patients understand their medications, scheduling follow-up visits, and flagging high-risk members before problems escalate. The shift reframes care transitions from a clinical courtesy into a core financial and quality strategy, with the first day out of the hospital treated as the moment that matters most.

More in Payers

Payers

7 Health System Insurers to Exit Medicare Advantage in 2027

Seven health system-owned insurers are among 11 health plans exiting the individual Medicare Advantage market in 2027, with several others narrowing to special needs plans only.

Why it matters: The exits signal that even provider-owned plans are struggling with Medicare Advantage economics, forcing seniors to find new coverage.

Payers

CMS Projects Lower MA Premiums, Flat Enrollment for 2027

CMS projects lower average Medicare Advantage premiums and flat enrollment of 34 million for 2027, a figure that already trails current membership of 36.1 million.

Why it matters: Medicare Advantage now covers nearly half of all Medicare enrollees, so its premium and growth trajectory shapes revenue for insurers, providers, and the federal budget.

Payers

PBMs Become Rare Bipartisan Target in Washington and States

A bipartisan push in Congress and statehouses aims to rein in pharmacy benefit managers, including proposals to force CVS and rivals to split their PBM and pharmacy businesses.

Why it matters: PBMs sit at the center of US drug pricing, and forced divestiture would upend the business models of the largest healthcare conglomerates.