Medicaid Managed Care
Expert articles and analysis related to medicaid managed care.
AI Summary ā Last 7 Days
CMSās Medicaid agenda this week centered on the CMMI GENEROUS Model, with all 50 states applying to participate in a most-favored-nation drug pricing model projected to generate $64.3 billion in savingsācreating a major new lever for Medicaid managed care plans, state agencies, and VBC contractors to manage pharmacy trend and total cost of care risk (AJMC). The Trump administration is also signaling tighter operational accountability across managed care: community engagement/work-requirement implementation raises churn and coverage-continuity risks for Medicaid populations, while AMA pressure to preserve CMSās 2027 electronic prior authorization deadline points to growing scrutiny of payer administrative friction that directly affects care management and access (Fierce Healthcare.
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