Advisory for Health Plans
Rebellis Group supports health plans operating in Medicare Advantage, Medicaid, and Commercial markets. We help leadership teams understand regulatory change, quantify financial impact, and align product and growth strategy.
Our work spans:
Expansion Strategy
Evaluating new markets and products to drive sustainable growth.
Operating Model Evolution
Transitioning from outsourced to insourced or hybrid models to improve efficiency and control.
Growth and Performance Improvement
Increasing enrollment, revenue, and margin through targeted initiatives and operational enhancements.
Compliance and Quality Management
Applying deep CMS regulatory expertise to resolve issues, improve audit readiness, and strengthen CMS relationships.
Financial and Operational Turnaround
Addressing deficiencies that impact financial results, quality performance, or overall plan stability.
Medicare Advantage, C-SNP & D-SNP Advisory
Rebellis Group advises Medicare Advantage health plans — including Chronic Condition Special Needs Plans (C-SNPs) and Dual Eligible Special Needs Plans (D-SNPs) — navigating CMS policy reform, pharmacy, clinical, operations, V28 risk adjustment, Stars pressure, bid strategy decisions and more.
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We translate regulation into financial and product-level strategy.
Core Advisory Areas
Risk Adjustment & Financial Modeling
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V28 impact analysis
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Diagnosis-level revenue modeling
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Product-specific sensitivity testing
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C-SNP and D-SNP population analytics
Bid & Product Strategy
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Bid development advisory
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Competitive positioning
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Benefit and product optimization
Regulatory Strategy
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CMS Final Rule interpretation
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RADV risk analysis
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D-SNP integration compliance advisory
Growth Alignment
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Market expansion analysis
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Enrollment performance analytics
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Distribution and broker strategy alignment
Medicaid Managed Care Advisory
Rebellis Group partners with Medicaid managed care organizations navigating state regulatory reform, rate adequacy pressure, procurement cycles, and program oversight.
Core Advisory Areas
Rate & Financial Modeling
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Capitation analysis
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Revenue sensitivity modeling
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Financial performance diagnostics
Regulatory & Compliance Strategy
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State policy interpretation
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Program integrity advisory
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Audit and oversight readiness
Procurement & Growth Strategy
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RFP response support
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Market expansion analysis
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Product and performance alignment
Commercial & ACA Exchange Strategy Advisory
Rebellis Group supports commercial and ACA exchange plans navigating pricing volatility, regulatory shifts, and competitive market dynamics.
Core Advisory Areas
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Pricing and risk pool modeling
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Regulatory compliance advisory
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Product performance evaluation
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Competitive positioning strategy