Managed Care Operations
Expert articles and analysis related to managed care operations.
AI Summary — Last 7 Days
Medicare Advantage is showing sharper county-level instability heading into 2027: premiums may be easing in some markets, but plan exits and uneven MA-PD availability are reducing beneficiary choice in certain counties, with KFF finding a modest decline in enrollees having 40+ MA-PD options and some large insurers exiting far more counties than they enter (KFF). That volatility matters for ACOs and VBC providers because MA network, attribution, and risk-contract economics may shift quickly, while KFF’s finding that 74% of MA enrollees could face Medigap denial due to pre-existing conditions raises the stakes of MA disenrollment decisions and continuity-of-care planning (KFF). In Medicaid managed care, states are continuing to use enhanced care coordination for children with chronic and complex needs as a population-health lever, while operational focus is shifting toward eligibility/redetermination readiness and access preservation—key pressure points for plans, pediatric systems, and community-based partners managing high-need cohorts.
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US lost 24,000 hospital beds as rural, urban facilities shuttered
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