Managed Care

Why Did Elevance Lose Its Medicare Star Ratings Lawsuit?
Management & Administration Why Did Elevance Lose Its Medicare Star Ratings Lawsuit?

In a striking development that has sent ripples through the healthcare industry, Elevance Health, a prominent name in the Medicare Advantage (MA) market, recently faced a significant legal setback in a federal court in Texas. The case, decided on August 19 of this year, revolved around the star

LCMC Health Braces for Medicaid Cuts with Bold Strategies
Management & Administration LCMC Health Braces for Medicaid Cuts with Bold Strategies

In the heart of New Orleans, a critical challenge looms over LCMC Health, a safety-net nonprofit hospital system serving as a lifeline for many vulnerable patients, as it grapples with the fallout from significant Medicaid cuts following the recent passage of the One Big Beautiful Bill Act. With

How Is Kaiser Permanente Boosting Revenue Amid Challenges?
Management & Administration How Is Kaiser Permanente Boosting Revenue Amid Challenges?

In the ever-evolving landscape of healthcare, where financial stability often collides with systemic hurdles, Kaiser Permanente stands out with a remarkable performance that has caught the attention of industry watchers. Amid rising costs, policy shifts, and changing patient needs, this healthcare

Firstsource and Guidehealth Partner for AI-Driven Care Innovation
Management & Administration Firstsource and Guidehealth Partner for AI-Driven Care Innovation

In a groundbreaking move for the healthcare sector, Firstsource Solutions Limited, a Mumbai-based titan in business management services, has forged a strategic alliance with Guidehealth, a Dallas-based trailblazer in value-based care solutions. This recently unveiled partnership is set to redefine

How Is Prior Authorization Evolving in Medicaid Programs?
Management & Administration How Is Prior Authorization Evolving in Medicaid Programs?

In the complex landscape of healthcare access, prior authorization (PA) within Medicaid programs stands as a critical yet contentious mechanism, often blamed for delaying essential care for millions of enrollees. A recent analysis by leading health policy organizations sheds light on the evolving

Highmark Health and Abridge Revolutionize AI in Healthcare
Management & Administration Highmark Health and Abridge Revolutionize AI in Healthcare

Imagine a healthcare system where administrative burdens no longer delay critical patient care, and doctors can focus entirely on their patients rather than paperwork, transforming the way medical services are delivered. This vision is becoming a reality through a groundbreaking partnership between

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