Private insurers that administer Medicaid for the poor also face limits on profits and requirements to provide sufficient doctors.
Maryland’s prisons and jails release thousands of inmates each year without helping them enroll in Medicaid, jeopardizing their health and putting communities at greater risk.
Last year’s Baltimore unrest highlighted deep distrust between police and poor African-Americans. Dozens of interviews and little-seen data show a similar gap between that community and the city’s renowned health system.
Major changes in broker compensation are designed to discourage enrollment of the sickest, say consumer advocates.
This new generation of so-called “skinny plans” can save employers money, but it’s not yet clear if they will meet regulatory scrutiny.
Orthopedist Michael Reilly believes the surge of doctors going to work for hospitals is not a healthy trend. He had a firsthand view of what can happen.
Workplace wellness programs have joined doctors, hospitals and your mother in the campaign to get you healthy. Will they treat your data carefully?
A large variety of information may be collected by wellness programs and shared with others, including businesses eager to make a buck off of it.
Even as premiums for employer-based insurance increased only moderately this year, deductibles rose faster than total spending.
Hospital ownership of doctors’ practices “dramatically increases” odds that a doctor will admit patients there instead of another, nearby hospital, researchers say.
An ambitious demonstration to transform clinics into “medical homes” treating patients in the community instead of the hospital didn’t save money. Some blame the test, not the idea.
By marrying partners with employer health plans, people in same-sex relationships are more likely to gain coverage.
The 6-3 ruling stopped a challenge that would have erased subsidies in at least 34 states for individuals and families buying insurance through the federal government’s online marketplace.
Don’t assume your employer’s health plan offers comprehensive coverage. Marlene Allen did. Then she got hurt.
Management of the joint state-federal program for low-income people has changed dramatically, and federal officials are seeking to make sure it meets the needs of enrollees.
Despite efforts to keep costs down, Douglas White gets a bill nearly three times what he expected.
The Centers for Medicare & Medicaid Services proposal, which includes provisions related to network adequacy and quality standards, would be the biggest regulatory change to Medicaid managed care in more than a decade.
A small consulting firm is disrupting hospitals’ business as usual by encouraging employers to pay much less than what hospitals bill — based on its analysis of what is reasonable.
As part of an experiment run by the Centers for Medicare and Medicaid Innovation, doctors, nurses and managers at Baptist Health System in San Antonio joined forces to cut costs for hip and knee replacements, getting patients on their feet sooner, saving taxpayers money and increasing their own earnings.
Tennessee’s TennCare program awaits federal rules to limit insurer profits and set stricter standards for quality and doctor networks — the biggest rules change for Medicaid managed care in a decade.