MA Bid Design Fly-In: Mastering Strategy for 2026

01/31/2025

Our immersive two-day workshop focused on Medicare Advantage bid strategy and supplemental benefit design. This comprehensive event brought together product development leaders, actuaries, and financial strategists to explore market trends, innovative product design, and advanced approaches to refining bid strategies for 2026.

 

Day One: Market Landscape and Bid Strategy

Wakely Consulting kicked off the event with a "MAPD State of the Union," examining critical considerations for the 2026 pricing season. The discussion covered post-election policy implications, Inflation Reduction Act impacts, PBM reform developments, and the evolution of risk adjustment with V28 implementation.

The team then led sessions on advanced bid preparation strategies, exploring regulatory updates, MA and PD bid components, and innovative approaches to rebate and subsidy strategies. Participants gained insights into managing subsidy range uncertainty and implementing effective risk mitigation measures.

The day concluded with deep dives into bid optimization and data-driven actuarial strategies for cost management, including techniques for efficient utilization and managing high-cost members.

 

Day Two: Supplemental Benefits and Future Outlook

Deft Research opened the second day with valuable insights into MA shopping trends and key factors driving purchasing decisions among seniors. This market intelligence set the stage for two robust sessions led by Melissa Smith of Newton Smith Group, focusing on critical decision points in supplemental benefit design and the art of balancing cost-effectiveness with value.

Participants engaged in strategic small-group discussions during an interactive working session, applying concepts learned to real-world scenarios. SelectHealth's Kaleb Holt shared how his organization is evolving its approach to measuring medical, drug, and supplemental benefit expenses, complemented by Wakely's insights on evaluating spending efficiency and optimizing benefit allocations.

The event concluded with Wakely's forward-looking examination of Medicare in 2029, including analysis of MedPAC recommendations and potential changes to the bid process.

 

Participating Organizations and Learnings

The event brought together leaders from several Alliance member organizations including Presbyterian Health Plan, CCHP, Health First Health Plans, CHRISTUS Health Plan, SelectHealth, HealthTeam Advantage, CommunityCare, Health New England, Quartz Health Solutions, and Health Alliance Medical Plans. This diverse mix of participants enabled rich discussions and peer learning opportunities throughout the sessions.

All Alliance Members can access presentation materials and additional resources through the Documents tab on the meeting page. The insights shared during this workshop underscore the importance of staying ahead of industry changes and mastering best practices in competitive and evolving markets.