NAVIGATING THE FOG SERIES 

The 2027 Operating Reset


A field guide for health plan leaders executing 2027 and preparing for the 2028 bid

Health plans are heading into a year with more moving pieces than at any point in the last decade. Each pressure strains margins and operations on its own. Together, they expose how an operation is put together, and where there may be accountability gaps. This guide helps your leadership team identify them.

 

 

Get the field guide
 

Built to be used, not just read
 

1. What's changing.
A one-page brief and timeline, from this fall's Star Ratings through the June 2027 deadline for 2028 bids.

2. A six-move resilience checklist.
18 actions resilient plans are taking now, each with a clear owner and a definition of "done."

3. The fragmentation tax worksheet.
Map your vendors, spot the warning signs and size what's at stake in MLR, Star Ratings, risk adjustment and Medicaid membership, against your own premium.

Health Plan Guide Form Image 3

For the leaders who own the outcome 

CEOs, COOs, CFOs and CMOs, plus the leaders responsible for quality, Stars, risk adjustment, medical management and operations. It works best as a working session with your leadership team.

 

An hour well spent

    • A clear view of the policy and market changes shaping 2027 and the 2028 bid
    • A score showing which resilience moves your plan has in place and which are still open
    • A map of your vendors, handoffs and accountability gaps
    • A sense of what's at stake in your own numbers, and where to start

Want a second set of eyes? 

Book a 30-minute Operating Model Briefing with a health plan operations leader from COPE Health Solutions. We'll map how your operation actually runs today, vendors and handoffs included, and show the three places we'd look first before your 2028 bid.

Book a Session


Note: This guide is for general planning purposes and reflects information available as of October 2026 from CMS and other public sources. Regulations and timelines may change and vary by state. Worksheet estimates are directional, not precise, and results are not guaranteed.

© 2026 COPE Health Solutions

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