Managed Care

Florida's $4M Plea to Save Canadian Drug Import Program
Management & Administration Florida's $4M Plea to Save Canadian Drug Import Program

In a striking move to address soaring prescription drug costs, Florida has embarked on a groundbreaking initiative to import cheaper medications from Canada, becoming the first state to gain approval from the Food and Drug Administration (FDA) for such a program in early 2024. However, this

How Can We Hold Health Insurers Accountable for Care Delays?
Management & Administration How Can We Hold Health Insurers Accountable for Care Delays?

Imagine a patient with a chronic illness waiting weeks for a critical treatment, only to be told that their health insurer requires additional paperwork through a process called prior authorization, delaying care at a pivotal moment when they need it most. This scenario is far too common in the

Mortality Gap in Medicare Advantage: Puerto Rico vs. US Mainland
Management & Administration Mortality Gap in Medicare Advantage: Puerto Rico vs. US Mainland

The disparity in health outcomes for Medicare Advantage (MA) enrollees between Puerto Rico (PR) and the US mainland represents a critical challenge in the American health care system, demanding urgent scrutiny and action to address systemic inequities. Recent research spanning from 2010 to 2022

How Will Trump's Health Cost Cuts Impact Molina Healthcare?
Management & Administration How Will Trump's Health Cost Cuts Impact Molina Healthcare?

The healthcare industry stands at a critical juncture as President Trump’s aggressive push to slash health insurance costs sends ripples through the sector, directly affecting companies like Molina Healthcare Inc. (NYSE: MOH), a major player in managed care and Medicaid services. With a focus on

How Is WellSpan Health Leading in Value-Based Care Excellence?
Management & Administration How Is WellSpan Health Leading in Value-Based Care Excellence?

In the ever-evolving landscape of healthcare, where the balance between quality and cost often seems elusive, one organization stands out as a beacon of innovation and effectiveness. WellSpan Health, an integrated delivery system serving Central Pennsylvania and Northern Maryland, has earned

Health DG Slams Insurers for Meddling in Clinical Decisions
Management & Administration Health DG Slams Insurers for Meddling in Clinical Decisions

In a striking development that has sent ripples through Malaysia's healthcare sector, Dr. Mahathar Abd Wahab, the Health Director-General, has issued a powerful reprimand to health insurers and third-party administrators for overstepping into the realm of clinical decision-making, highlighting a

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