America’s Health Insurance Plans (AHIP) recently issued an amicus brief in support of states covering MMCO’s health insurance tax.
The national payer organization has also been lobbying...
Introducing a public option could encourage commercial payers to lower their premiums, a trend reflected in increased competition from Medicaid managed care organizations, researchers from the Urban...
North Carolina’s transition from a fee-for-service (FFS) model to Medicaid managed care has faced some challenges, but keeping open communication lines with stakeholders enables the state’s...
Polling from Modern Medicaid Alliance revealed most Americans support the Medicaid program. Similarly, only one in five Americans reported they support cuts to the program’s...
WellCare Health Plans will divest its Medicaid programs in Missouri and Nebraska to Anthem, Inc. as part of its merger with Centene Corporation, Centene announced.
"This agreement represents an...
After seven years of instability and decreasing involvement from payers, the Affordable Care Act exchanges, or the federal health insurance marketplace, will expand in 2020, the Robert Wood Johnson...
Randy Hyun, the chief executive officer from Aetna Better Health, apologized at a public hearing in front of the KanCare oversight committee for Aetna Better Health’s mismanagement of the...
Louisiana Healthcare Connections (LHCC), whose parent firm is Centene, and Aetna have filed protests against Louisiana’s Medicaid managed care contract awards, The Advocate reported.
“Our...
Iowa’s Department of Human Services will be raising privatized Medicaid capitation rates by 8.6 percent and has signed contracts from Amerigroup Iowa and Iowa Total Care for fiscal year (FY)...
In an unprecedented move, Colorado’s Attorney General Phil Weiser pursued an antitrust challenge against the FTC-approved vertical merger of UnitedHealth Group and DaVita Medical Group.
Weiser,...
Managed care giant Centene Corporation has announced that it will acquire rival payer WellCare Health Plans, Inc. for $17.3 billion in cash and stock.
The latest mega-deal among key players in the...
A report on social determinants of health (SDOH) has five recommendations for addressing these important but often overlooked health factors with effective policymaking.
The Center for Health Care...
CMS has proposed a new rule to reduce regulation around Medicaid managed care programs and allow states to contract with private payers to deliver managed care at faster rates.
CMS developed the rule...
Commercial and managed care payers experienced significant third quarter profits, reductions in healthcare spending, and enrollment growth, according to the latest financial statements from insurance...
North Carolina has received a 1115 waiver from CMS allowing the state to implement a Medicaid managed care system administered through private payers.
The state’s Department of Health and Human...
Pharmacy benefit managers (PBMs) with specialized drug formularies can help managed care payers significantly reduce prescription drug costs, according to new research published in the Journal of...
AmeriHealth Caritas has successfully reduced opioid dependency rates among managed care beneficiaries through member engagement and data analytics techniques that promote alternatives to opioid...
Managed care payers experienced a 5.7 percent increase in administrative plan costs in 2017, for items such as staffing and customer service support, according to an analysis from the Sherlock...
Medicaid beneficiaries face significant food insecurity challenges and may require additional healthcare programs to reduce food insecurity risks, according to new research from the Root Cause...
Managed care payers and state Medicaid agencies are finding it difficult to find personnel to administer long-term support services (LTSS) within home and community-based settings (HCBS), says a new...
