Naya Kehayes, managing principal and CEO of Eveia Health Consulting and Management, recommends hospitals and other providers ask payors these four questions regarding benefit plan incentives within ...
Amidst the backdrop of large-scale consolidation across the US health care system, consolidation among Medicaid managed care ...
John Michael O'Brien, PharmD, MPH, discussed the changes in managed care over the past 30 years to commemorate the 30th anniversary of The American Journal of Managed Care®. Over my 30 years in health ...
Applying Managed Care Principles to a Pharmacy Benefit Program For the Indigent The pharmacy benefit provided to indigent patients by state or federal programs is of utmost importance to maintaining ...
UnitedHealth (UNH) and peers face significant margin risk after the CMS's 2027 Medicare Advantage rate proposal fell short of ...
In American healthcare, Medicaid presents significant challenges, particularly regarding inpatient stay approvals. In recent years, Medicare and the Two-Midnight Rule have dominated discussions around ...
Advances in biomarker-driven and individualized approaches in neurology and psychiatry will require new frameworks for value ...
Medicaid managed care has become the dominant form of Medicaid delivery in the United States, with 41 states (including Washington, DC), using managed care organizations (MCOs) to provide access to ...
As early as the first quarter of next year, government management of non-covered medical treatments frequently claimed under real-loss insurance, such as manual therapy and extracorporeal shockwave ...
Capella Healthcare announced the hiring of Laurie Hash as director of managed care and Cindy Goehring as director of benefits. In her newly created position, Hash (pictured) will oversee managed care ...
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