Georgia’s Department of Community Health (DCH) is preparing to reprocure its Medicaid managed care contracts (currently held by Amerigroup, CareSource and Peach State Health Plan). DCH’s selection process will begin later this year/early next year for new contracts to go-live…
To many, managed care is managed care. But with the leverage and bottom-line impact of an ASC to a physician group or hospital system, planning a specific strategy is essential to account for market forces that have significantly changed the…
Healthcare operations continue to stride forward in new directions; Forbes published an article this week detailing how BCBSGA, UHC and Aetna are running pilot programs where they are directly employing providers that circumnavigate the existing healthcare delivery systems. From the…
CMS announced that will be heightening audits to “confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees”. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.
Physicians and Hospitals experienced over $68 billion in Medicare and Medicaid reimbursement shortfalls. The cost of care is out growing the reimbursement from Medicare and Medicaid. Yet few physicians are leaving their contract new survey shows.
Developments continue regarding the proposed mergers between Anthem/Cigna and Aetna/Humana. Yesterday, the Justice Department reported they will likely file lawsuits this month to halt both proposed mergers. If the Justice Department does take action, it may significantly delay any merger. …
Strategic Healthcare Partners (SHP) continues our series on Health Exchanges and impact on providers. Please join us this Wed, 10/16 from 4pEST – 5pEST. Contact Jason Crosby at jcrosby@shpllc.com or 912-544-0421 with any questions. Space is limited, please reserve your seat…