Managed Care
Expert articles and analysis related to managed care.
AI Summary — Last 24 Hours
The Trump administration’s HHS is deferring more than $1B in Medicaid payments to California and Minnesota over alleged fraud and noncompliance, escalating federal-state tensions around Medicaid financing and creating near-term cash-flow and risk-management uncertainty for Medicaid managed care plans, safety-net systems, and VBC contractors in affected states. At the same time, congressional momentum is building around Medicare Advantage prior authorization reform, with provider groups backing the Improving Seniors’ Timely Access to Care Act and related MA transparency measures, while new Health Affairs analysis on MA prior authorization and disenrollment adds pressure on plans to show that utilization management supports appropriate care rather than undermining access. Medicaid managed care is also under renewed scrutiny as stakeholders debate whether MCOs still deliver sufficient administrative and population-health value, including concerns about VBC provisions in the Medicaid state directed payment rule.
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Medicaid managed care delivers value
From newsletter: Managed Care as Medicaid’s Administrative Architecture: Does It Still Provide Value to States? Assessing how well MCOs perform their core functions ...
Managed Care as Medicaid’s Administrative Architecture: Does It Still Provide Value to States? | Milbank Memorial Fund
From newsletter: Managed Care as Medicaid’s Administrative Architecture: Does It Still Provide Value to States? Assessing how well MCOs perform their core functions ...
Prior Authorization In Medicare Advantage: Beneficiary Exposure And Plan Disenrollment In 2021
Prior Authorization In Medicare Advantage: Beneficiary Exposure And Plan Disenrollment In 2021 Health Affairs
(July 21, 2026) MGMA Statement on the Improving Seniors' Timely Access to Care Act
(July 21, 2026) MGMA Statement on the Improving Seniors' Timely Access to Care Act Medical Group Management Association - MGMA
ASCO Applauds House Energy and Commerce Committee Vote Advancing Prior Authorization Reform Bill; Calls for Full Floor Vote
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CMS proposes more restrictions on provider taxes that fund Medicaid
CMS proposes more restrictions on provider taxes that fund Medicaid Modern Healthcare
HHS pauses $1B in Medicaid payments to California, Minnesota
HHS pauses $1B in Medicaid payments to California, Minnesota Healthcare Finance News
Trump administration says it’s deferring $1B in Medicaid payments to California and Minnesota
The Trump administration said it was deferring more than $1 billion in Medicaid payments to Minnesota and California because of “suspected fraud and noncompliance.”
Medicaid Family Planning Programs: A Critical Coverage Pathway in the Wake of H.R. 1
Medicaid Family Planning Programs: A Critical Coverage Pathway in the Wake of H.R. 1 Manatt, Phelps & Phillips, LLP