Managed Care

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

Cook Children’s Health Plan Fights Texas Medicaid Contract Cancellation
Management & Administration Cook Children’s Health Plan Fights Texas Medicaid Contract Cancellation

The Cook Children’s Health Plan (CCHP) has been a steadfast provider of Medicaid services to low-income families in North Texas for over two decades. Recently, however, it found itself in the throes of a heated dispute with the Texas Health and Human Services Commission (HHSC), which decided not to

Will Medicare Advantage Costs Rise and Benefits Shrink in 2025?
Management & Administration Will Medicare Advantage Costs Rise and Benefits Shrink in 2025?

As 2025 approaches, significant changes in Medicare Advantage plans are on the horizon that could affect millions of seniors across the United States. This article delves into what these changes entail, why they’re happening, and how they will impact plan members and providers. Current

Is Prior Authorization Hindering Patient Care and Burdening Doctors?
Management & Administration Is Prior Authorization Hindering Patient Care and Burdening Doctors?

The healthcare industry continually evolves, and one of the perennial issues impacting both patient care and healthcare providers is the practice of prior authorization by health insurers. The American Medical Association (AMA) has recently undertaken significant policy changes to enhance insurer

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