Why PACE Programs Require Stronger Enrollment and Agent Operations
PACE programs serve some of the most complex populations in health care. The Program of All-Inclusive Care for the Elderly helps eligible older adults receive coordinated medical and social services while continuing to live in the community when possible. CMS notes that most PACE participants are dually eligible for both Medicare and Medicaid, making the […]
What Every Medicaid Health Plan Needs to Know About Working with Agents and Brokers
As Medicaid managed care organizations expand into Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs), success depends on more than benefit design. Building a scalable, compliant agent and broker operation is becoming a critical competitive advantage. Medicaid and Medicare Are Becoming Increasingly Connected For decades, Medicaid managed care organizations and Medicare Advantage plans operated […]
How Health Plans Can Better Support FMOs and Agencies
Field marketing organizations (FMOs) and agencies play a major role in how health plans grow. They help plans reach new markets, activate agent networks, support enrollment, and build stronger relationships with brokers and members. For Medicare Advantage, Medicaid, D-SNP, individual market plans, and other health insurance products, these partner relationships can be a significant growth […]
The Growth Bottleneck No One Talks About
Health Plans Are Optimized for Operations, Not for Growth When I talk with health plan leaders, I hear a familiar frustration: growth feels harder than it should. The instinct is to blame the market. Sometimes it’s regulation, other times it’s the competition. But in my experience, the real issue is internal. Most health plans are […]
The Danger of “Good Enough” Technology that Normalizes Friction
Why “Good Enough” Front-Office Systems Quietly Stall Health Plan Growth For years, health plans have invested heavily in back-office systems. Claims, billing, compliance, and enrollment platforms are stable, mature, and deeply entrenched. And that’s the problem. Because while back offices are optimized for operational stability, growth happens somewhere else entirely. Growth happens in the front […]
Health Plans Are Rebuilding Their Tech Stack Around Distribution, Not Homegrown Solutions
For years, health plans have relied on systems to manage distribution that were never designed for it. Sometimes those systems were off-the-shelf CRMs. More often, they were homegrown combinations of spreadsheets, legacy tools, and heavily customized software stitched together over time. These systems became the center of the tech stack not because they were the […]
Inside Abacus — Why We Built It and What It Changes for Health Plans
Insuring Growth explores the biggest challenges and opportunities facing health insurance leaders, focusing on what executives need to know now. In our latest episode of Insuring Growth, I sat down with Kyle Mitchell, our VP of Product, to talk about one thing at the center of every plan’s growth challenges: distribution. For years, plans have invested […]
How 2026 Will Reshape Open Enrollment for Agents
For more than a decade, brokers and agents have adapted to steady changes in the Affordable Care Act (ACA) marketplace. Deadlines shifted, subsidy structures evolved, and new compliance requirements arrived in waves. But January 2026 represents something different — not just incremental adjustments, but a structural shift in how agents will experience open enrollment. This […]
Strategic Revenue Management: The 6-Step Plan to Market Leadership
In the final post of this series, e123 President Brendan McLoughlin recaps the detailed 6-step guide on how you can implement the Strategic Revenue Management (SRM) framework within your organization. Over the past few months, the Strategic Revenue Management (SRM) blog series has walked you through the process of how to use data to focus your […]
Strategic Revenue Management Step 6: Repeat
How carriers grow smarter with SRM as a cycle