BluePeak Advisors, Author at BluePeak Advisors

Introducing the ADVISE Framework – Six Imperatives for 2027 Audit Readiness

To help plans, delegates, and PBMs navigate what’s ahead, BluePeak has developed the ADVISE Framework, a practical, action oriented readiness model aligned to the operational challenges highlighted in the proposed…

BluePeak AdvisorsMarch 31, 2026

ICYMI: CY 2027 Model of Care — What SNP Plans Need to Know

Why CY 2027 Is Different On March 26, 2026, BluePeak provided a free webinar on 2027 MOC Readiness. During the webinar, Beth Brooks, Director of Medicare Part C, emphasized that…

BluePeak AdvisorsMarch 31, 2026

MFN Pricing Moves from Policy to Practice: What GUARD Means for Medicare Part D

CMS is entering a new phase of federal drug pricing reform, moving the Most Favored Nation (MFN) concept from policy signaling into direct implementation. For Medicare Part D stakeholders, the…

BluePeak AdvisorsMarch 31, 2026

Insight Article

5 Actions to Take Now for a Strong 2027 Medicare Advantage Bid

With Medicare Advantage bids due June 1 for the 2027 plan year, plan sponsors face a compressed window in which they must complete numerous activities amid medical cost trend and…

BluePeak AdvisorsMarch 13, 2026

Insight Article

Maintaining Medicare Advantage Audit Readiness in 2026 and Beyond

Aiming for a comprehensive view of plans’ overall compliance, CMS this year is unleashing a host of changes to Medicare Advantage program audits. With the first batch of audit notices…

BluePeak AdvisorsMarch 13, 2026

Compliance & Regulatory Updates Leadership & Organizational Insights

Preparing for the Future of PACE Audits: A Deep Dive into the Updated 2026 CMS PACE Audit Protocol

Medicare Advantage organizations facing program audits in 2026 will encounter an unusual batch of changes. These changes, revealed in a November CMS memo, are intended to streamline the process and…

BluePeak AdvisorsFebruary 23, 2026

Compliance & Regulatory Updates Leadership & Organizational Insights

Top Medicare Advantage Plan Strategies for 2026 CMS Audit Changes

Medicare Advantage organizations facing program audits in 2026 will encounter an unusual batch of changes. These changes, revealed in a November CMS memo, are intended to streamline the process and…

BluePeak AdvisorsJanuary 30, 2026

Compliance & Regulatory Updates Leadership & Organizational Insights Winter 2025

Annual CPE Audit – Compliance as a Strategic Asset

Annual CPE audits are required by CMS, but their value goes beyond compliance. These audits assess the effectiveness of your compliance program, identify gaps, and prevent fraud, waste, and abuse.…

BluePeak AdvisorsDecember 3, 2025

Leadership & Organizational Insights Quality & Star Ratings Winter 2025

Stars – Driving Growth, Revenue, and Reputation

Star Ratings are more than numbers—they determine your plan’s financial health, market position, and member loyalty. Every interaction matters, from member experience to clinical outcomes and pharmacy adherence. High ratings…

BluePeak AdvisorsDecember 3, 2025

Secret Shopper on Phone at Computer from Home

Medicare Advantage Operations Member Experience / CAHPS Winter 2025

Secret Shopping – See Your Plan Through the Member’s Eyes

Secret shopping is one of the most effective ways to understand how your plan performs in real-world scenarios. By posing as prospective members, these evaluations reveal whether your call center…

BluePeak AdvisorsDecember 3, 2025

BluePeak Advisors

5 Actions to Take Now for a Strong 2027 Medicare Advantage Bid

Maintaining Medicare Advantage Audit Readiness in 2026 and Beyond

Preparing for the Future of PACE Audits: A Deep Dive into the Updated 2026 CMS PACE Audit Protocol

Top Medicare Advantage Plan Strategies for 2026 CMS Audit Changes

Annual CPE Audit – Compliance as a Strategic Asset

Stars – Driving Growth, Revenue, and Reputation

Secret Shopping – See Your Plan Through the Member’s Eyes

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