Medicare Advantage outlook

The 2028 pledge makes functional GI a 2026 decision.

Health plans covering 165 million lives have pledged outcome-based payment structures by January 2028. This report works backward from that date for functional GI care.

Inside the report

What the report covers.

165mlives covered by the payer pledge
1 in 3adults 65+ meeting Rome IV DGBI criteria
5.7xmodeled gross ROI
  1. Why the January 2028 pledge becomes a 2026 contracting decision.
  2. Where the functional GI care gap sits in your 65+ population.
  3. What Nerva platform data says about engagement among members aged 65 and over.
  4. How to structure pay for verified success on ACCESS-like rails.
  5. An ROI model that plans can rerun with their own population and claims data.

The payer pledge spans Medicare Advantage, Medicaid, and private insurance. Plans can rerun the ROI model using their own population and claims data.