Medicare Advantage
Payment accuracy, star ratings that measure care rather than paperwork, and guardrails on marketing practices that mislead seniors.
- MA for Tomorrow framework
- 2027 Rate Notice comments
- Risk adjustment integrity
Policy
Federal policy, argued from the front line of care.
ACHP works across five priority areas where the structure of nonprofit, provider-aligned plans produces a materially different answer than the rest of the industry.
Medicaid
Protecting continuous coverage, simplifying eligibility verification and funding the plans that serve complex populations.
- Community engagement rule
- Redetermination operations
- Managed care rate setting
Drug pricing
Negotiation implementation, PBM transparency and biosimilar adoption that reaches the premium, not just the pipeline.
- IRA implementation
- PBM reform
- Site-of-care pricing
Individual market
Stabilizing subsidies, keeping marketplace competition local and preventing a coverage cliff for working families.
- Enhanced subsidies
- Plan integrity
- Rating rules
Digital transformation
Interoperability, prior authorization automation and responsible use of AI in coverage decisions.
- Prior auth APIs
- AI governance
- Data exchange standards