Medicaid plans’ business model succeeds on exchanges where others struggle

The success of smaller insurers with extensive Medicaid experience may offer a model that could stabilize the Affordable Care Act marketplace exchanges, according to Roll Call.

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How CMS proposes to align Medicaid managed care with private plans

Among the many provisions in the newly finalized rule for Medicaid managed care, the federal government seeks to align MMC regulations with ones that govern other privately managed plans.

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Overlapping coverage can help mitigate churn

Five states have already reported a 14 percent decline in Affordable Care Act marketplace enrollment, an early projection that raises concerns that the rest of the country will see increased churn throughout the year, according to Investor’s Business Daily.

 

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Medicaid managed care rule: Health plans, state directors cautiously optimistic

Medicaid directors and health plans have mixed feelings about the newly finalized federal regulations for Medicaid managed care plans.

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CMS takes hands off approach to HIE, MU in new Medicaid managed care rule

The new final Medicaid and CHIP managed care rule does not change Meaningful Use, data exchange and health IT requirements, despite commenters’ requests to do so.

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Medicare Advantage, pharma costs among AHIP’s top five focus areas

America’s Health Insurance Plans CEO Marilyn Tavenner described the top five areas where she hopes to focus AHIP’s efforts in her keynote speech Wednesday at the National Quality Forum’s annual conference in the District of Columbia.

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Iowa implements Medicaid managed care program

Iowa has officially moved its Medicaid program from fee-for-service to a managed care model led by three private insurers, AmeriHealth Caritas Iowa, Amerigroup Iowa and UnitedHealthcare of the River Valley, reports The Gazette of Cedar Rapids…

Centene finalizes merger with Health Net

Centene has finalized its merger with Health Net, creating the largest Medicaid managed care organization in the country while two other major insurer mergers still await regulatory approval.

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How WellCare Meets the Needs of Medicaid patients: Q&A with CEO Ken Burdick

Next week, WellCare CEO Ken Burdick will present at AHIP’s National Health Policy Conference in Washington, D.C. His session will focus on managing complex health conditions among diverse populations in public programs, such as Medicaid and Medicare Advantage. Burdick shared some of his insights with AHIP Coverage ahead of the event. Continue reading

Finding Innovation in Medicaid Managed Care

Today, Medicaid serves nearly 70 million Americans, which is roughly 20 percent of the U.S. population. While Medicaid is a necessity for its beneficiaries, it has also become a proving ground for health care innovation. Continue reading

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