The American Medical Association is overhauling how U.S. doctors report and bill for pregnancy services, bulldozing the current system of bundled payments and replacing it with more granular, itemized ...

Kevin Dowdy, director of managed care for Meridian Surgical Partners, shares three tactics to improve your chances at successful managed care contract negotiations, and one you should avoid. 1. Know ...

The managed care rule’s importance can hardly be overstated. As of 2022, three-quarters of states relied on managed care as a basic element of their Medicaid state plan administration. Over 80 percent ...

Workforce shortages, regulatory complexities and economic challenges have put hospitals and health systems under immense pressure to improve operational efficiency, accelerate payments and reduce ...

Coding of physician office visits can be very confusing – and is ever-changing. Every year, regulations and guidelines change, and it is difficult for providers to keep up. Most groups have coding ...

Massachusetts has finalized a deal with the Centers for Medicare and Medicaid Services to test the agency’s capitated financial alignment model for Medicare-Medicaid dual eligible beneficiaries, ...

Amidst the backdrop of large-scale consolidation across the US health care system, consolidation among Medicaid managed care plans threatens the health and long-term stability of Medicaid managed care ...