Mike Adelberg is a Senior Director at FaegreBD Consulting. Before joining Faegre, Mike held several senior positions within the Centers for Medicare and Medicaid Services (CMS), including concurrently serving as the director of the Insurance Programs Group and the acting director of the Exchange Policy and Operations Group in the Center for Consumer Information and Insurance Oversight (CCIIO). In these roles, Mike was responsible for setting policy and implementing critical Health Insurance Exchange operations, including plan management, eligibility and enrollment, the small-business health options program (SHOP), and the Co-Op loans. Prior to that, Mike was the Director of Medicare Advantage Operations, where he supervised the annual cycle for review and award of Medicare Advantage contracts and led monitoring of Medicare Advantage plans. His other senior roles at CMS included serving as the associate regional administrator for Medicare operations (Chicago Region) and the director of education and assistance programs. Mike’s industry experience includes serving as the Vice President for Product Development and Vice President of Government Affairs for a health insurer.
Recent Posts by Mike Adelberg
One non-medical service---transportation to medical appointments---has been part of Medicaid since its inception in 1966 and addresses one of the socioeconomic disadvantages that prevent Medicaid beneficiaries from accessing health services.
Many insurers have ably managed their sicker- and poorer-than-expected Marketplace membership by borrowing from the playbook of the most similar market, Medicaid. Health plans must employ this playbook to well-serve a population that both parties believe needs coverage.
An important part of the effort towards increased transparency of provider networks is the implementation of standardized, machine-readable provider directories. This advance in network information and transparency comes at an important time -- as policymakers consider new balances between...
One day, ACA Marketplace plans may cover many of the 11 percent of Americans who remain uninsured. But the three programs---reinsurance, risk corridors, and risk adjustment---that the ACA’s drafters hoped would help stabilize premiums in the revamped markets have not performed as expected.