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 […]
Enhanced Direct Enrollment (EDE): What Health Plans Should Know
You may have been hearing a buzz around Enhanced Directed Enrollment (EDE). Let us break down what it is, why it’s valuable for health plans, and how it’s different from direct enrollment. We’ll also share some information about mPulse’s EDE solution to give you an idea of how a software vendor can help. What is […]
5 Reasons to Act Now on CMS’s Interoperability & Prior Auth Rules
If your organization hasn’t yet started planning for CMS-0057-F, now’s the time to rethink your strategy. While this regulation introduces new ways to streamline prior authorizations and improve data sharing, it also comes with serious implications for those who delay action. In this post, we’ll explore what could go wrong if you ignore the rule—or […]
Maximize the Value of Your Member Portal: 3 Key Strategies – Part 1
Maximize the Value of Your Member Portal: 3 Key Strategies The member portal is the face of your health plan to your members and plays a critical role in members’ health journeys. It is often the most visible and meaningful touchpoint that members have with their benefits. Health plans make a significant investment in standing up a member portal, but are you getting the most return on that investment?
2025 Trends in Health Plan Consumer Engagement
In 2025, health plans must navigate tightening regulations, capitalize on the opportunity of generative AI capabilities and deliver more personalized consumer experiences, all while creating efficiencies to address workforce capacity issues and operating in a more cost-conscious healthcare environment. As the healthcare landscape rapidly evolves, doing the above successfully will help health plans adapt to […]
The Power of Combining Automated and 1-1 Digital Outreach
Automation and Consumer Expectations Automation and digital technology have helped transform the way that we navigate healthcare as consumers, allowing for faster, higher-quality access to information and resources at scale. Automation technology has also served to deliver significant operational efficiencies across the healthcare ecosystem, freeing up skilled human resources to focus on complex issues that […]
Digital Strategies to Improve Medication Adherence
Medication adherence, while critical for managing chronic conditions like diabetes, high cholesterol, and cardiovascular disease, has still proven to be a struggle for many Americans.
Top 4 Strategies to Retain D-SNP Members
But First, Who are SNPs? A special needs plan (SNP) is a Medicare Advantage (MA) coordinated care plan (CCP) specifically designed to provide targeted care and limit enrollment to individuals with special needs. There are three SNP categories: Dual Eligible SNP Chronic Condition SNP, and Institutional SNP What is a D-SNP? Dual Eligible Special […]
Overcoming Member Barriers to Breast Cancer Screenings
1 in 8 women in the United States will get diagnosed with Breast Cancer in her lifetime. This means that every two minutes, someone in the U.S. is newly diagnosed. When detected early, the 5-year survival rate is 99%, but advanced stage breast cancer can be fatal. Early detection through annual mammograms can help treat […]
3 Ways Health Information Technology Improves Health Outcomes
It’s no secret that better provider-member relations can often lead to better health outcomes for the member and improved financial performance for the health plan. Building trust, enhancing communication, and personalizing care through health information technology not only fosters better provider-member relationships but also improves health outcomes and the financial performance of health plans. When […]