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Payer & Insurance Markets

Expert articles and analysis related to payer & insurance markets.

9 articles•Last 24 Hours

AI Summary — Last 24 Hours

Synthesis: In the last 24 hours, CMS under the Trump administration has proposed a 2.4% hospital pay increase and is advancing a new mandatory joint replacement model, signaling continued pressure on hospital payment innovation and risk-based contracting. Meanwhile, California policy leaders are floating ambitious models to unify Medi-Cal network administration and financing, including proposals to integrate In-Home Supportive Services (IHSS) into managed care for improved coordination—an approach with significant implications for Medicaid value-based care and population health management. For ACOs and payer strategists, these developments underscore rising expectations for administrative integration, alternative payment models, and comprehensive care delivery redesign at both federal and state levels. Sources: CMS floats 2.4% hospital pay bump, mandatory CJR model, Medi-Cal Bold Idea — IHSS Integration into Managed Care

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