Managed Care

How Does Switching to Traditional Medicare Impact Mental Health Care?
Management & Administration How Does Switching to Traditional Medicare Impact Mental Health Care?

Imagine a 68-year-old retiree, grappling with chronic depression, who finds themselves unable to see a psychiatrist under their Medicare Advantage plan due to a frustratingly narrow network of providers. After months of delays and denials for critical care, they make the leap to Traditional

From Visits to Value: What Payers Expect From Home Care
Management & Administration From Visits to Value: What Payers Expect From Home Care

Demand for home-based care has surged while payment models have become tangled enough to stall promising partnerships, and that tension has left providers wondering why negotiations that start with enthusiasm often end with a familiar deadlock over rates and utilization edits. The answer sits in a

Function, Nest, Revian Signal Shift to Augmented Care
Management & Administration Function, Nest, Revian Signal Shift to Augmented Care

The center of gravity in digital health has been drifting from episodic treatment to an always-on model that anticipates risk, enriches clinician judgment, and meets patients where they live, and three fresh financings set the tone for what comes next across software, services, and devices. Capital

AI Tool Uses Routine Blood Tests to Speed TB Screening
Management & Administration AI Tool Uses Routine Blood Tests to Speed TB Screening

In clinics where every minute and dollar count, a screening tool built on routine blood work and machine learning promises to move patients faster toward answers and treatment by turning familiar lab values into early signals of tuberculosis risk that are cheap to collect, easy to interpret, and

States Brace for Medicaid Home Care Cuts Under H.R. 1 Law
Management & Administration States Brace for Medicaid Home Care Cuts Under H.R. 1 Law

As the reconciliation law known as H.R. 1 casts a long shadow over the landscape of healthcare funding, states across the U.S. are confronting an unprecedented challenge in sustaining Medicaid programs for home care services. These services, often referred to as home- and community-based services

How Can Connecticut Solve Its Healthcare Affordability Crisis?
Management & Administration How Can Connecticut Solve Its Healthcare Affordability Crisis?

In Connecticut, the escalating cost of healthcare has become a daunting barrier for many residents, with nearly two-thirds of adults admitting to delaying or skipping necessary medical care due to financial constraints, according to recent data from Healthcare Value Hub. This alarming trend not

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