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 ...

2025 SEP 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News-- Investigators publish new report on Managed Care. According to news reporting out of Providence, Rhode Island, by ...

Kevin Dowdy, director of managed care for Meridian Surgical Partners, shares three tactics to improve your chances at successful managed care contract negotiations, and one you should avoid. 1. Know ...

CMS issued a final rule Tuesday preventing states from increasing or adding pass-through payments for hospitals, physicians or nursing homes contracted with Medicaid managed care organizations. Here ...

Contract negotiations adhere to a rule that 80 percent of time should be used to prepare for the negotiation and 20 percent to negotiate. To help be more effective in achieving results when you ...

On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance and Quality Final Rule, a final rule that ...

Recently, the Department of Health and Human Services (“HHS”), Office of the Inspector General (“OIG”), HHS’s Centers for Medicare & Medicaid Services (“CMS”), and Congress have focused attention on ...

A government watchdog is ringing the alarm on potential quality and access issues in Medicaid managed care, when states contract with private companies to administer the care of Medicaid beneficiaries ...

Health care spending in 2019 reached $3.8 trillion, 17.7 percent of the gross domestic product in the United States. Likewise, employer-sponsored health insurance premiums — which cover about 157 ...

This article presents a detailed descriptive analysis of how Massachusetts and Minnesota implemented Medicaid accountable care organization (ACO) models for their managed care population. CMS aims to ...