Digital Experience Isn’t One-Size-Fits-All: How High-Impact Health Events Are Reshaping Member Trust
CMS prior auth changes are exposing gaps in legacy processes. Learn how mPulse automates UM communications to secure compliance, scale volume, and improve CAHPS
The Star Ratings Ground Is Moving. Your Strategy Shouldn’t Depend on Where It Settles.
As CMS sets a 30-day clock for member outreach, the line between members who keep their coverage and those who lose it will come down to communication clarity. Learn what the Interim Final Rule requires, who it applies to, and how plans can deploy compliant, plain-language outreach before the mandatory window closes June 30, 2026.
Meeting Medicaid’s New Community Engagement Requirements
As CMS sets a 30-day clock for member outreach, the line between members who keep their coverage and those who lose it will come down to communication clarity. Learn what the Interim Final Rule requires, who it applies to, and how plans can deploy compliant, plain-language outreach before the mandatory window closes June 30, 2026.
Modernizing Utilization Management Communications to Meet CMS Prior Authorization Requirements
Learn how health plans can modernize utilization management communications to meet CMS prior authorization timelines, improve notification compliance, and reduce operational strain.
Using Member Analytics to Drive Actionable Engagement for Health Plans
Health plans today face both significant challenges and unprecedented opportunities to drive meaningful change. Disparities in care still impact too many, and nearly 9 out of 10 U.S. adults continue to struggle to understand and act on their health information. Yet at the same time, the technology, data, and digital engagement tools available today uniquely […]
How to Improve CAHPS Performance: An Action Plan for 2026
CAHPS surveys have long been central to measuring health plan performance, but their influence has grown significantly. With member experience now carrying greater weight in Star Ratings, plans must move beyond treating CAHPS as a compliance exercise. It is no longer enough to simply measure member experience — the challenge is to improve it in […]
2026 Star Ratings Retrospective: Stabilization Without Breakthrough
Introduction Following the release of the 2026 Star Ratings in October, Medicare Advantage and Prescription Drug Plans (MA-PD) have had time to digest results that signal a pivotal shift in the industry landscape. After years of steady decline, ratings have stabilized, but meaningful improvement remains elusive. As plans navigate heightened regulatory scrutiny, evolving measure weights, […]
CMS-0057F Compliance Guide for Health Plans: Step-by-Step Roadmap to Interoperability & Prior Authorization
Webinar CMS Interoperability Rules: Why Health Plans Shouldn’t Wait to Prepare 2 Sep 2025 | 9 min read Read Blog The Centers for Medicare & Medicaid Services’ CMS-0057F interoperability and prior authorization rule marks a major shift in how health plans manage compliance and member care. While the most complex requirements don’t take effect until […]
ACA Open Enrollment 2026: 5 Key Steps for Success
The 2025 ACA Open Enrollment Period marked a significant milestone, with over 24 million consumers selecting affordable health coverage through the Marketplace. This record-breaking participation highlights the increasing demand for accessible, consumer-friendly health insurance options. As carriers prepare for Open Enrollment Period (OEP) 2026, success will depend on more than just meeting deadlines—it requires strategic […]
Driving Member-Centric Outcomes: Key Strategies and Takeaways from mPulse’s HOS Webinar
As Health Outcomes Survey (HOS) measures gain weight in Medicare Stars Ratings, prioritizing member-perceived health is more critical than ever. Recently, mPulse and Rex Wallace Consulting hosted an in-depth webinar exploring how health plans can refine their HOS strategies to drive meaningful, member-centric outcomes. Below, we summarize the key insights and takeaways to support your […]