Over the past few decades, 38 states and the District of Columbia have switched their Medicaid plans to some form of managed care for at least part of their government programs.
Nurie Keqi, of Queens, N.Y., is one of the lucky ones benefiting from Medicaid expansion under the Patient Protection and Affordable Care Act. A year ago, her Medicaid plan dropped her and her husband because of a small increase in their household income. The 63-year-old Albanian native, a U.S. citizen since 2007, lost coverage for the pills that kept her high blood pressure in check and lessened her chronic back pain from years of lifting heavy parcels for a small package carrier. Her husband could no longer afford his asthma medications.
“It was difficult. I had no job at that point and drugs are so expensive, and we weren't sure what we were going to do,” Keqi said.
It wasn't until New York expanded Medicaid for people earning above the poverty line that she was enrolled in Health Plus, an Amerigroup Medicaid managed-care plan. Now, the couple are once again filling their prescriptions. “When Obamacare came around, we thanked God,” she said.
Read the full story here: http://bit.ly/1mbNxFK
Source: Modern Healthcare
Health Care Utilization and Cost of Diagnostic Testing for Respiratory Infections
September 17th 2025Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
Read More
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
Listen
Infertility Coverage Boosts ART Use and Pregnancy Success: Richard A. Brook, MS, MBA
August 26th 2025In this episode, Richard A. Brook, MS, MBA, discusses his study showing that infertility treatment coverage increases assisted reproductive technology (ART) use and improves pregnancy outcomes.
Listen