On May 10, 2024, the Centers for Medicare & Medicaid Services (CMS) published the Medicaid and Children’s Health Insurance Program (CHIP) Managed Care final rule in the Federal Register. The final ...

Centene (CNC) and Oscar Health (OSCR) were among notable gainers in the managed care space on Monday after Barclays upgraded ...

To mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the ...

With the announcement of the nursing home minimum staffing rule, I asked myself the same question as operators nationwide: how on earth are we going to pay for this? Even if nursing homes could find ...

U.S. managed healthcare insurers are currently going through a significant transformation, driven by rising medical costs, increased regulatory scrutiny and a surge in investments focused on data, ...

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 ...

Naya Kehayes, managing principal and CEO of Eveia Health Consulting and Management, recommends that hospitals and other providers ask payors these 11 questions regarding termination of managed care ...

Connecticut’s Medicaid program boasts lower costs and similar levels of access when compared to peer states, according to a report by independent consultants, leading to the conclusion that employing ...

The contracts were awarded after Mississippi Medicaid issued one-year emergency contracts last month to Magnolia Health, Molina Healthcare and UnitedHealthcare – the companies currently contracting ...

Explore the stages and prevalence of chronic kidney disease, highlighting risk factors and the importance of early detection ...