Managed Care

The healthcare payer industry is continually evolving, driven by substantial funding rounds, significant policy changes, legislative enactments, and legal actions. Staying updated with these developments is crucial for stakeholders to navigate the complexities of the healthcare landscape. This

Proposition 35, appearing on the November 5 general election ballot, proposes significant changes to California's Medi-Cal program. Medi-Cal, the state's version of the federal Medicaid program, provides health insurance to low-income residents. This measure garnered widespread support

Steward Health Care System, a prominent Dallas-based healthcare organization, faces a critical financial juncture. The company is grappling with significant operational challenges, particularly within its hospital division. Recently, in a bid to stabilize its finances amid bankruptcy proceedings,

Medicaid is a pivotal safety net for millions of low-income and disabled Americans, providing access to critical health services, including prenatal care for pregnant women. Recent findings, however, have exposed glaring inefficiencies in Virginia's Medicaid managed care organizations (MCOs)

The Cook Children’s Health Plan (CCHP) has been a steadfast provider of Medicaid services to low-income families in North Texas for over two decades. Recently, however, it found itself in the throes of a heated dispute with the Texas Health and Human Services Commission (HHSC), which decided not to

As 2025 approaches, significant changes in Medicare Advantage plans are on the horizon that could affect millions of seniors across the United States. This article delves into what these changes entail, why they’re happening, and how they will impact plan members and providers. Current b