Managed Care Programs
Expert articles and analysis related to managed care programs.
AI Summary — Last 24 Hours
CMS’s Medicare Advantage rulemaking is drawing immediate attention because proposed 2027 changes could reshape plan economics, benefit design, risk adjustment, and prior authorization practices—pressuring MA plans, delegated provider groups, and ACO-aligned networks to reassess coding, utilization management, and care management strategies now (MA 2027 proposal coverage). At the same time, health plans are emphasizing progress on prior authorization streamlining, while Medicaid managed care remains under scrutiny through state payment redesigns, fraud enforcement, and drug-pricing proposals—signaling a tighter operating environment for VBC organizations managing total cost of care across Medicare and Medicaid populations ([AHIP prior authorization update](https://news.google.com/rss/articles/CBMimgFBVV95cUxOTHRPY2d3dmpnV0NZR0dmVzM1MjUzQnhQ
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