Within the first six months of President Trump’s second term, his Administration and the GOP have already implemented significant policies that are reshaping health care in the United States. Through ...

Managed care organizations (MCOs), which primarily offer medical and pharmaceutical benefit plans, play a central role in the United States healthcare system. By managing health plans for individuals ...

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 (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over ...

Idaho health officials say it’ll take years to switch all Idaho Medicaid benefits to being managed by private companies. Through a sweeping bill meant to cut Medicaid costs, the Idaho Legislature this ...

In our state, managed care organizations (MCOs) safeguard access to critical and comprehensive health care services for nearly one in two New Mexicans. Under the Medicaid Turquoise Care program, it is ...

Minnesota is reviewing Medicaid spending to fight fraud, but the scope is limited Managed care organizations responsible for billions of dollars in social services spending have been left out of a key ...

LAS VEGAS — Many long-term care providers need to get up to speed on how they can receive better treatment from managed care organizations, especially with greater opportunities starting Jan. 1. That ...

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.

Dedicated cyber solution offers up to $25 million in primary and excess coverage for managed care organizations TAMPA, Fla.--(BUSINESS WIRE)-- MSITM, one of the largest independent managing general ...

Given the prevalence of managed care, it’s incumbent upon the industry to ensure that there is a robust supplier pool. The discrepancy between the percentage of payments made to MCOs and individuals ...