Managed Care

Medicaid Transition Leaves Adult Day Attendees Stranded Without Rides
Management & Administration Medicaid Transition Leaves Adult Day Attendees Stranded Without Rides

Recent changes to Indiana's Medicaid program have left many adult day service attendees struggling to access essential care and socialization opportunities. The state's transition to managed care, dubbed PathWays, has resulted in the abrupt termination of transportation services vital to families

Audit Reveals $7 Million Overpay in PA Medicaid Drug Benefits for 2022
Management & Administration Audit Reveals $7 Million Overpay in PA Medicaid Drug Benefits for 2022

Delving into significant financial mismanagement uncovered by Pennsylvania Auditor General Timothy L. DeFoor, this article shines a light on the state's Medicaid prescription drug benefits. It underscores substantial fiscal oversight issues and calls for urgent reforms. The audit has revealed that

Healthcare Payer Developments: Funding, Policy Changes, and Legal Actions
Management & Administration Healthcare Payer Developments: Funding, Policy Changes, and Legal Actions

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

How Will Proposition 35 Reform Medi-Cal Funding in California?
Management & Administration How Will Proposition 35 Reform Medi-Cal Funding in California?

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 from local

Can Steward Health Survive Bankruptcy by Selling Managed-Care Division?
Management & Administration Can Steward Health Survive Bankruptcy by Selling Managed-Care Division?

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,

Virginia Medicaid's Managed Care Fails to Link Pregnant Women to Care
Management & Administration Virginia Medicaid's Managed Care Fails to Link Pregnant Women to Care

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) that

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