Managed Care & Networks
Expert articles and analysis related to managed care & networks.
AI Summary — Last 7 Days
Network friction in Medicare Advantage intensified this week, with CarolinaEast dropping BCBS Medicare Advantage and delaying a UnitedHealthcare exit while broader scrutiny grew over mid-year provider terminations that leave beneficiaries locked into plans—raising renewed concerns for VBC organizations about attribution stability, access guarantees, and downside-risk performance when networks shift after enrollment. At the same time, ACO advocates gained momentum on reducing MSSP reporting burden, while bipartisan prior authorization reform and criticism of MA risk pricing signaled a converging policy focus on administrative burden, plan accountability, and whether managed care incentives are distorting care access rather than improving value ([NAACOS on ACO reporting relief](https://news.google.com/rss/articles/CBMizAFBVV95cUxOUjF2Q3NFNFhOVDQ3MnhHbTV2UjRfLXhSTWNNckhuQjlrTmx1N0NFUEdwcjdBSEQyM3BqSXQ1M1dJUzViM0xjQWowTFNkQlRNRGtHN3gzYlVzamROR3JWTnphUzF2T2sxekVmSjlwYnN1YlZQdG9rdXZSQkJKV3hiNmtJWXdXd3dzZmlxNmRQZkphRF95Q0ZzMTh3UHhaMXl4eWZFM1QtVmVBRElid2xfX
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Q&A: Revised Model Legislation: An Act to Reduce Prescription Drug Costs Using Medicare Maximum Fair Price Reference-Based Pricing
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Northwell, Fidelis face network split affecting 240,000 patients
Northwell, Fidelis face network split affecting 240,000 patients  Becker's Hospital Review