January/February/March Volume 21, Issue 1 First Report Managed Care
Feature
Cover Story
03/01/2024
In 2022, Medicare Advantage plans covered 50% of Medicare enrollees, costing the federal government $403 billion, while 81% of Medicaid enrollees received care through managed care for $254 billion. The Health and Human Services Office of...
In 2022, Medicare Advantage plans covered 50% of Medicare enrollees, costing the federal government $403 billion, while 81% of Medicaid enrollees received care through managed care for $254 billion. The Health and Human Services Office of...
In 2022, Medicare Advantage...
03/01/2024
First Report Managed Care
Feature Story
03/01/2024
PwC's Health Research Institute surveyed health plan actuaries covering nearly 100 million employer-sponsored and 10 million Affordable Care Act marketplace members to project medical cost trends for 2023-2024, highlighting factors like...
PwC's Health Research Institute surveyed health plan actuaries covering nearly 100 million employer-sponsored and 10 million Affordable Care Act marketplace members to project medical cost trends for 2023-2024, highlighting factors like...
PwC's Health Research Institute...
03/01/2024
First Report Managed Care
Department
Managed Care Q&A
03/01/2024
Featuring John Stahl, Senior Director, Consulting at Clarivate and Matthew Arnold, Principal Analyst at Clarivate
Featuring John Stahl, Senior Director...
Experts from Clarivate discuss the evolving pharmaceutical landscape in 2024, emphasizing the need for payers to balance supporting innovative breakthrough medicines with containing health care costs.
Experts from Clarivate discuss the evolving pharmaceutical landscape in 2024, emphasizing the need for payers to balance supporting innovative breakthrough medicines with containing health care costs.
Experts from Clarivate discuss...
03/01/2024
First Report Managed Care
Insights
Commentary
03/01/2024
Amit Gupta, MD, Medical Director, Clinical Strategy at Sagility
Amit Gupta, MD, Medical Director, Cli...
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is...
03/01/2024
First Report Managed Care
Commentary
03/01/2024
Michael Gould, AVP, Interoperability Strategy at ZeOmega
Michael Gould, AVP, Interoperability ...
CMS has published the Interoperability and Prior Authorization final rule to drive transformative outcomes in the health care ecosystem, requiring payers and providers to adopt new standards and FHIR APIs to reduce inefficiencies and improve...
CMS has published the Interoperability and Prior Authorization final rule to drive transformative outcomes in the health care ecosystem, requiring payers and providers to adopt new standards and FHIR APIs to reduce inefficiencies and improve...
CMS has published the...
03/01/2024
First Report Managed Care
