This is the first in a regular series of interviews spotlighting Anne Tumlinson, a contributor to Park Place Live, and the founder and president of ATI Advisory. She specializes in value-based care, MA, and other issues pertinent to the long-term care community.

In a rarity, there will be a decline in the number of Medicaid Advantage (MA) plan offerings from the previous year, according to CMS in its Contract Year (CY) 2026 Medicare Advantage (MA) and Part D landscape file.

But top healthcare expert and long-term care specialist Anne Tumlinson tells Park Place Live there will be little impact on the skilled nursing sector, noting the overall MA plan offering downtick comes at the same time there are more Special Needs Plans (SNPs) coming for the 2026 plan year, including a bump higher in provider-led Institutional-SNPs (I-SNPs).

Tumlinson, founder and CEO of ATI Advisory in Washington, DC, said MA plans available for 2026 are expected to decrease from 5,633 in 2025 to approximately 5,600, which she called more of a function of insurers picking their spots more carefully.

“There have been a lot of cuts to the MA program and that has impacted where health plans have wanted to offer products in 2026,” Tumlinson said.

To note, CMS said overall MA enrollment is projected to slip to 34 million in 2026, a decline from the 2025 level of 34.9 million in 2025.

On the flip side, SNPs will see more growth with 1,797 SNPs available in 2026, a 33 percent advance from this year. The strongest gains will come from Chronic Condition-SNPs (C-SNPs), with projections for 556 plans, or a 42 percent jump from 2025. Dual Eligible SNPs (D-SNP) will offer 1,085 plans, a 15 percent rise year-on-year, and I-SNPs available are expected to decline 5 percent year-on-year, even though provider-led plans are expected to continue to grow as the larger insurers shrink their presence, Tumlinson said.

“Most I-SNPs continue to be on offer in the Eastern part of the nation, and general growth appears to be concentrated among provider-led entities. However, slower growth compared to other SNP types might indicate concerns with taking risk for a low-density population, and competing with larger insurers serving residents,” she said.

C-SNPs continue to be an attractive product option for organizations seeking targeted approaches to serving people with complex needs, according to analysis by ATI Advisory. There are also evolving policy dynamics (e.g., Value-Based Insurance Design (VBID) sunsetting) that will continue to bolster C-SNP as a strong product, Tumlinson said.

“C-SNPs allow plans to offer a tailored benefit design on top of a targeted care model across the full membership, avoiding the operational complexities of determining eligibility within a plan,” she said.

C-SNPs are SNPs that restrict enrollment to special needs individuals with specific severe or disabling chronic conditions. An example of the growth for 2026 in these plans is that in 2025 there were 288 plans targeted for those with cardiovascular conditions. For 2026, CMS said 478 such plans are on offer, an increase of 66 percent year-on-year from 2025.

CMS said despite the projections for an overall decline in MA enrollment, it expects more people to eventually sign up. The agency stressed the stability in pricing and offerings for 2026. The average monthly plan premium across all MA plans, which includes MA plans that provide prescription drug coverage and SNPs, is estimated by CMS to decrease from $16.40 in 2025 to $14.00 in 2026.

CMS said benefit options will remain stable, including MA supplemental benefit offerings such as hearing, dental, and vision.

“Based on plans’ projections, enrollment in MA is projected to be 34 million in 2026, a decrease from 34.9 million in 2025, with MA enrollment representing approximately 48 percent of all people enrolled in Medicare, compared to 50 percent in 2025. However, based on recent historical experience and enrollment trends, CMS anticipates that enrollment in MA in 2026 will be more robust than the plans’ projections and that enrollment will be stable,” the agency said. 

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.