HPA Clinical Leaders Fly-In 2026

The 2026 Market & Regulatory Outlook: What Clinical Leaders Need to Know is a strategic briefing focused on the financial, regulatory and operational forces shaping health plan performance and planning for the year ahead.

The session is scheduled for September 16, 2026, at 8:15 a.m.as part of the Health Plan Alliance Clinical Leaders Fly-In.

The session will cover medical cost and utilization trends, 2027 Star Ratings and regulatory updates, and specialty pharmacy and regulatory impacts on health plan strategy and operations.

The session is particularly relevant for health plan clinical leaders, Chief Medical Officers, Chief Clinical Officers, pharmacy leaders, nurse leaders and healthcare executives responsible for clinical, financial and operational performance.

Clinical leaders should pay close attention to medical cost and utilization trends, changing member needs, workforce pressures, regulatory developments, specialty pharmacy dynamics and the evolving economics of healthcare delivery.

Changes to 2027 Star Ratings and the regulatory environment can influence health plan strategy, clinical priorities, operational planning and performance. The session will explore the implications of these evolving requirements for health plan leaders.

Medical cost and utilization trends directly influence health plan economics and clinical performance. Understanding these trends can help health plans identify opportunities to improve utilization, manage costs and balance better outcomes with sustainable economics.

Utilization Management can help health plans support appropriate care, improve clinical decision-making and manage healthcare costs. HealthHelp, a WNS company, highlights AI-powered Utilization Management, clinical expertise, data and analytics and intelligent operations as capabilities that can help health plans drive operational and financial value.

AI, combined with clinical expertise, data and analytics, can help health plans simplify complex processes, support faster clinical decisions, improve provider experiences and optimize healthcare operations.

Health plans can improve care management ROI by evaluating clinical programs across the member journey, optimizing resources, identifying high-impact interventions and using data and analytics to measure clinical and financial outcomes. The broader Clinical Leaders Fly-In agenda also addresses integration of utilization management, case management, disease management and vendor partnerships.

Specialty pharmacy is an increasingly important consideration for health plan strategy because of its potential impact on healthcare costs, utilization, clinical management and regulatory considerations. The session specifically addresses emerging specialty pharmacy and regulatory impacts.