Managed Care

300,000 Pennsylvanians Risk Losing Medicaid Coverage Soon
Management & Administration 300,000 Pennsylvanians Risk Losing Medicaid Coverage Soon

In Pennsylvania, a pressing crisis looms over the healthcare landscape as federal cuts tied to legislation from the Trump administration threaten to strip Medicaid coverage from an estimated 300,000 residents, highlighting the profound impact of a federal tax and spending bill that slashes health

Why Are Medicaid Insurers Leaving Illinois Providers Struggling?
Management & Administration Why Are Medicaid Insurers Leaving Illinois Providers Struggling?

In the heart of Illinois, a profound crisis is unfolding within the state's Medicaid managed care system, creating a dire situation for healthcare providers who are battling severe financial and operational hurdles due to the practices of private insurers. This system, designed to streamline costs

How Can Smart IT Fix Duplicate Medicaid Enrollments?
Management & Administration How Can Smart IT Fix Duplicate Medicaid Enrollments?

The challenge of duplicate enrollments in Medicaid and the Children’s Health Insurance Program (CHIP) has quietly siphoned off billions of taxpayer dollars for years, creating a financial burden that undermines the efficiency of these critical healthcare programs. This issue arises when

Why Is CareOregon Limiting Out-of-Network Mental Health Care?
Management & Administration Why Is CareOregon Limiting Out-of-Network Mental Health Care?

In a healthcare landscape increasingly defined by rising costs and funding uncertainties, a significant policy shift by CareOregon, a Portland, Oregon-based nonprofit managed care organization, has sparked attention and concern among its members and industry observers. This nonprofit, the largest

How Are Employers Tackling Rising Specialty Drug Costs?
Management & Administration How Are Employers Tackling Rising Specialty Drug Costs?

The escalating expense of specialty drugs, critical for treating complex conditions such as cancer and rare diseases, has emerged as a pressing issue for employers and health plans across the healthcare landscape, demanding urgent and innovative solutions. With these medications accounting for a

Can Centene Overcome Its Legal Challenges and Restore Trust?
Management & Administration Can Centene Overcome Its Legal Challenges and Restore Trust?

Centene Corporation, a leading player in government-sponsored healthcare programs, has found itself embroiled in a significant legal quagmire, with allegations of securities fraud and corporate misrepresentation taking center stage. This high-profile class-action lawsuit has instilled a sense of

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