The purpose of market insurance is to protect consumers from fluctuations in expenditures by charging each covered group a premium equal to its expected costs and then using the profits earned from ...
Others see the plan as undercutting insurance markets and a “consumerism fantasy" with crucial details lacking. The healthcare plan recently proposed by the Trump administration has some fans, but it ...
This article is part of a Health Affairs Forefront featured topic, Medicaid Financing. The featured topic includes analysis, proposals, and commentary that will inform policies on the state and ...
In American healthcare, Medicaid presents significant challenges, particularly regarding inpatient stay approvals. In recent years, Medicare and the Two-Midnight Rule have dominated discussions around ...
To mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the ...
Medicaid managed care organizations should prioritize children in low-opportunity neighborhoods to optimize health care utilization, improve minority health, and address health-related social needs.
U.S. managed healthcare insurers are currently going through a significant transformation, driven by rising medical costs, increased regulatory scrutiny and a surge in investments focused on data, ...
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