Episode
EP510: The Impact on You of Medicare Advantage Goings-on (2026 Edition), With Betsy Seals
- Podcast
- Relentless Health Value
- Published
- May 7, 2026
- Duration seconds
- 2130
- Processing state
not_requested- Canonical source
- https://cc-lnk.com/EP510
Actions
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Summary
Medicare Advantage 2026: Stabilization, Retrenchment, and a Back-to-Basics Playbook with Betsy Seals In Episode 510, Stacey Richter interviews Medicare Advantage (MA) consultant Betsy Seals about the 2026 state of MA and its broader impact, including taxpayer value, seniors' access to care, and cost shifting to commercial employers when vertically integrated carriers negotiate MA rates while employers pay higher ASO rates. Seals describes MA as in a stabilization/retraction phase with market exits, regulatory and administration shifts, and benefit pullbacks that can affect beneficiaries depending on whether plans cut "flashy" enrollment perks versus outcome-focused care. Her "back to basics" guidance emphasizes avoiding profiteering and compliance risks (e.g., upcoding, problematic AI-driven prior authorization), focusing on populations a plan can truly serve well (including chronic SNP strategies), and improving STARS through real health outcomes rather than box-checking. They discuss high prior-authorization denial overturn rates on appeal, downstream provider incentives, and the need for stronger process reform and regulatory "teeth," while noting confidence in MA's long-term viability. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP510 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV T…