Managed Care

Which Home Health Companies Will Transform Care in 2025?
Management & Administration Which Home Health Companies Will Transform Care in 2025?

In 2025, the home health care industry stands at a pivotal crossroads, driven by the relentless pursuit of innovation and strategic collaboration among leading companies. This transformation is fueled by companies harnessing cutting-edge technology and innovative business models, marking a new era

Transforming Healthcare: Shift to Profit-Driven Corporatization
Management & Administration Transforming Healthcare: Shift to Profit-Driven Corporatization

The U.S. healthcare landscape is undergoing profound changes as corporatization shifts its focus from traditional, non-profit models to profit-driven entities. This evolution smacks of a broader, intensified corporatization—transforming how healthcare operates on multiple levels and reshaping

Is Managed Care Facing Systemic Flaws in Risk Adjustment?
Management & Administration Is Managed Care Facing Systemic Flaws in Risk Adjustment?

The healthcare insurance landscape has been significantly disrupted by Centene Corporation's decision to retract its earnings guidance for the current year, highlighting potential systemic weaknesses in risk adjustment and cost management. With a reported $1.8 billion revenue gap attributed to risk

How Can We Combat Rampant Health Care Fraud in America?
Management & Administration How Can We Combat Rampant Health Care Fraud in America?

In recent years, the U.S. health care system has grappled with a persistent challenge that undermines both public trust and financial stability: rampant fraud. This pervasive issue is highlighted by a series of large-scale legal actions targeting fraudulent schemes across the nation, including

Could Capsule Sponge Revolutionize Oesophageal Cancer Monitoring?
Clinical & Pharma Could Capsule Sponge Revolutionize Oesophageal Cancer Monitoring?

Barrett's esophagus, a medical condition that can significantly increase the risk of developing esophageal cancer, has traditionally been monitored using endoscopic procedures. However, the advent of a groundbreaking capsule sponge test offers a less invasive alternative, potentially transforming

Will Prior Authorization Reforms Truly Transform Healthcare?
Management & Administration Will Prior Authorization Reforms Truly Transform Healthcare?

In a recent move signaling potential change within the healthcare domain, approximately 50 health insurance plans, including major entities like UnitedHealthcare, SCAN Health Plan, Kaiser Permanente, and Humana, have pledged to reduce the burden of prior authorizations. This commitment is part of a

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