Managed Care & Networks
Expert articles and analysis related to managed care & networks.
AI Summary — Last 24 Hours
Medicaid managed care stakeholders are facing a sharper compliance posture as HHS/CMS priorities under the Trump administration put fraud, waste, and abuse controls back in the foreground—raising near-term pressure on MCOs, delegated entities, and provider networks to tighten encounter data, program-integrity monitoring, and documentation before audits or enforcement actions accelerate (Forvis Mazars). At the same time, large insurers such as Elevance Health continue to center growth strategy on managed care scale and network performance, underscoring the tension for VBC leaders between expanding risk-based Medicaid/MA footprints and absorbing higher oversight, medical cost, and provider-access obligations ([AD HOC NEWS](https://news.google.com/rss/articles/CBMiyAFBVV95cUxOWTMyNExEWUhZdWpxbUNscjZYZzJNYl96WENod2t0YlkxdUpSbW84U1B5ems3UTRXQ0w4VjVaWW8zbi1hVVprLXpQYXlraGZTcjJLUnlxMHdORVF4OU9sTVhOVTlQeFNGaWtYeVBGNEhlb1o1ak9MWG14VzdnckRNaU9sV05xN1VRaTM0
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