Eight-month payer IT study recognizes top client-scored achievement in one of managed care's highest-return operating categories as health plans tighten 2026-2027 vendor selection around measurable ...

John Michael O'Brien, PharmD, MPH, discussed the changes in managed care over the past 30 years to commemorate the 30th anniversary of The American Journal of Managed Care®. Over my 30 years in health ...

Eight-month payer IT study recognizes Cotiviti's top client-scored achievement in claims editing, payment policy, administrative EDI and provider payment operations as health plans prepare for 2027 ...

Medicaid managed care has changed monumentally in the last three decades, from a system that was focused on managing costs to the managed care of today which is making demonstrable differences in ...

WE may soon know whether Congress will approve some version of President Obama’s health care plan. No matter what the outcome, there will be an unacknowledged monster lurking in the room: managed care ...

Leading publicly traded US managed care insurers are expected to report both sequential and year-over-year declines in net income for the fourth quarter of 2025. Beyond operating costs, insurers are ...

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 ...

Abstract: Much evidence points to the fact that managed care plans (health maintenance organizations and preferred provider insurance) reduce costs and offer value for money. Yet they apparently have ...

California, in a departure from previous policy, will not automatically enroll low-income elderly and disabled residents in managed care health plans during the next round of a three-year pilot ...