Payer Systems

How Can We Hold Health Insurers Accountable for Care Delays?
Management & Administration How Can We Hold Health Insurers Accountable for Care Delays?

Imagine a patient with a chronic illness waiting weeks for a critical treatment, only to be told that their health insurer requires additional paperwork through a process called prior authorization, delaying care at a pivotal moment when they need it most. This scenario is far too common in the

Mortality Gap in Medicare Advantage: Puerto Rico vs. US Mainland
Management & Administration Mortality Gap in Medicare Advantage: Puerto Rico vs. US Mainland

The disparity in health outcomes for Medicare Advantage (MA) enrollees between Puerto Rico (PR) and the US mainland represents a critical challenge in the American health care system, demanding urgent scrutiny and action to address systemic inequities. Recent research spanning from 2010 to 2022

How Will Trump's Health Cost Cuts Impact Molina Healthcare?
Management & Administration How Will Trump's Health Cost Cuts Impact Molina Healthcare?

The healthcare industry stands at a critical juncture as President Trump’s aggressive push to slash health insurance costs sends ripples through the sector, directly affecting companies like Molina Healthcare Inc. (NYSE: MOH), a major player in managed care and Medicaid services. With a focus on

Oregon's Bold Push for Universal Health Care in the U.S.
Management & Administration Oregon's Bold Push for Universal Health Care in the U.S.

In a nation where health care remains a divisive and often inaccessible necessity for millions of people, Oregon has emerged as a daring pioneer with a visionary plan to establish a universal, single-payer health care system that could transform lives. This ambitious endeavor, ignited by a 2022

France's Universal Healthcare: A Model of Equity and Access
Management & Administration France's Universal Healthcare: A Model of Equity and Access

France’s healthcare system is often celebrated as a global standard for fairness and accessibility, offering a compelling example of how universal coverage can transform public health outcomes while achieving impressive metrics. With a life expectancy of around 82 years—several years higher than in

How Are Rising Costs Threatening Medicaid in Connecticut?
Management & Administration How Are Rising Costs Threatening Medicaid in Connecticut?

Connecticut’s Medicaid program, widely recognized as HUSKY, stands at a precarious crossroads as it confronts unprecedented financial pressures that jeopardize its ability to serve nearly 926,700 low-income residents, including children, families, and individuals requiring long-term care. As one of

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